Adaptive control of medical devices based on clinician interactions

ABSTRACT

A method and system identifies interactions of a user with one or more medical devices, determines, based on the one or more interactions and a predetermined set of rules, a compliance score associated with the first user, in response to the compliance score not satisfying a threshold compliance score, and reducing an access level of the user to at least one of the one or more medical devices and generates a training program associated with the at least one medical device and the one or more interactions, and automatically, without user involvement, sends a training package associated with the training program to the user and notifies the user to complete the training program using the training package. The system and method also generates a new shift schedule for clinicians responsive to a first shift schedule not satisfying criteria and the clinicians not satisfying respective performance scores.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of priority as a nonprovisional ofU.S. Application Ser. No. 62/897,199, entitled “ADAPTIVE CONTROL OFMEDICAL DEVICES BASED ON CLINICIAN INTERACTIONS,” filed on Sep. 6, 2019,and claims the benefit of priority as a nonprovisional of U.S.Application Ser. No. 62/865,906, entitled “SYSTEMS AND METHODS FORIDENTIFYING NON-COMPLIANCE PATTERNS OF INTERACTIONS WITH A MEDICALDEVICE,” filed on Jun. 24, 2019, the entirety of each of which isincorporated herein by reference.

TECHNICAL FIELD

This application relates generally to controlling medical devices basedon an evaluation of clinicians and their respective interactions withmedical devices in a healthcare organizations.

BACKGROUND

Medical devices, such as infusion devices, provide various conveniencesand simplify administration of medications to patients by clinicians,such as nurses, of a health care facility. Healthcare facilities and themedical device manufacturers may establish various protocols and/orsafeguards to ensure that the fluid or medication is administered safelyand consistently by different clinicians with different experiences andlevels of training. However, due to the different experiences and levelsof training, actions of some clinicians may fall outside of a healthcarefacility's protocols, and risk safety of the patient and operations ofthe healthcare facility. Moreover, healthcare organizations utilizevarious systems from various vendors and clinicians with varying levelsof proficiency with the systems to assist in the treatment of thepatients. Accordingly, one concern healthcare organizations is toidentify and reduce operational risks to the healthcare organizationwhile improving operational efficiency. Existing healthcare systems,however, do not adequately identify the clinicians with low levels ofproficiency with one or more of the utilized systems, thus increasingrisk of injury to the patient and/or decreasing operational efficiencyof the healthcare organization.

SUMMARY

Various interactions of clinicians with different medical devices andsystems may increase operational risks for a healthcare organization.For example, a clinician may fail to follow one or more protocols inadministering medications to patients. Existing systems are not suitablyconfigured to track and monitor non-compliant clinician interactionsacross multiple medical devices. Healthcare organizations may also faceoperational risks from temporary or traveling clinicians with varyinglevels of training and expertise at using the different medical devicesand systems of the healthcare organization. Existing systems also cannotautomatically provide such clinicians with assistance to successfullycomplete their tasks in a manner to satisfy the best practices and/orprotocols standards or efficiently identify source centers withwell-trained temporary clinicians to reduce the operational risks.Furthermore, existing systems and methods do not allow for healthcareorganizations for efficiently specifying scheduling criteria andscheduling clinicians for shifts at a healthcare organization based onthe scheduling criteria. Additionally, operational risks of a healthcareorganization may increase due to improper and/or inefficient schedulingof clinicians for different shifts at the healthcare organization.

Accordingly, there is a need for systems and methods that can trackindividual clinician interactions, identify non-compliant interactions,generate training plans to address and/or rectify the non-compliantinteractions, thereby reducing the risk to patients and/or a healthcarefacility from non-compliant clinicians. There is also a need for systemsand methods that can identify clinicians that do not adhere to the bestpractices and/or protocols of a healthcare organization, adapt theoperation of a device within the organization to provide them withassistance to satisfy the best practices and/or protocols standards,identify source centers for additional well-trained clinicians, andallow scheduling systems of healthcare organizations to dynamically andefficiently schedule clinicians based on schedule criteria specified toreduce operational risks. The systems and methods disclosed herein areable to effectively identify non-compliant interactions of a clinicianand address them via training plans generated for that clinician,thereby reducing operational risks by increasing safety of the medicaldevices and systems used while treating patients.

According to various implementations, a method includes identifying oneor more interactions of a first user with one or more medical devices;determining, based on the one or more interactions and a predeterminedset of rules, a compliance score associated with the first user; inresponse to the compliance score not satisfying a threshold compliancescore, reducing an access level of the first user to at least one of theone or more medical devices and generating a training program associatedwith the at least one medical device and the one or more interactions,wherein reducing the access level includes reducing a number ofrespective features of the at least one medical device that areavailable to the first user; and automatically, without userinvolvement, sending a training package associated with the trainingprogram to the first user and notifying the first user to complete thetraining program using the training package.

According to some implementations, a method includes tracking one ormore interactions of a first user with one or more medical devices;determining, based on a set of stored rules and the one or moreinteractions, a compliance score; determining whether the compliancescore satisfies a threshold compliance score; in response to determiningthat the compliance score satisfies the threshold compliance score,generating, based on the one or more interactions, a training plan forthe first user; and adjusting, based on the training plan, one or morefeatures of the one or more medical devices available for the first userat the one or more medical devices.

In accordance with some implementations, a method includes identifyinginteractions of a plurality of clinicians with one or more medicaldevices, and generating, based on a set of stored rules and one or moreinteractions of each user of the plurality of clinicians, a performancescore for each of plurality of clinicians associated with theinteractions. The method includes receiving a first shift scheduleassociated with the plurality of clinicians, and determining whether thefirst shift schedule satisfies one or more scheduling criteriaassociated with the healthcare facility. In response to determining thatthe first shift schedule does not satisfy the one or more schedulingcriteria and a first performance score for a first clinician does notsatisfying a first evaluation threshold of the one or more schedulingcriteria, (1) generating a training plan for the clinician, or a newsecond shift schedule for the plurality of clinicians that replaces afirst clinician scheduled during a first time period with a secondclinician not currently scheduled during the time period based on asecond performance score of the second clinician, and (2) electronicallypreventing the first clinician from using at least one of the pluralityof medical devices during the first time period. The method includescausing the new schedule for the shift, or the training plan, to bedisplayed on a display device associated with a clinician schedulingsystem.

Other aspects include corresponding systems, apparatus, and computerprogram products for implementation of the foregoing methods.

In accordance with some implementations, a system includes a memorystoring instructions and one or more processors coupled with the memoryand configured to execute the instructions to cause the system toidentify interactions of a plurality of clinicians with one or moremedical devices, generate, based on a set of stored rules and one ormore interactions of each user of the plurality of clinicians, aperformance score for each of plurality of clinicians, receive a firstshift schedule associated with the plurality of clinicians. The one ormore processors are configured to execute the instructions to cause thesystem to determine whether the first shift schedule satisfies one ormore scheduling criteria associated with the healthcare facility, andwhen the first shift schedule does not satisfy the one or morescheduling criteria and a first performance score for a first cliniciannot satisfying a first evaluation threshold of the one or morescheduling criteria, (1) generate a new second shift schedule for theplurality of clinicians that replaces a first clinician scheduled duringa first time period with a second clinician not currently scheduledduring the time period based on a second performance score of the secondclinician, and (2) electronically prevent the first clinician from usingat least one of the plurality of medical devices during the first timeperiod. The one or more processors configured to execute instructions tocause the system to cause the new schedule for the shift to be displayedon a display device associated with a clinician scheduling system. Otheraspects include corresponding systems, apparatus, and computer programproducts for implementation of the system.

In accordance with some implementations, a device management serverincludes one or more processors and memory storing one or more programsconfigured for execution by the one or more processors. The one or moreprograms include instructions for performing the operations of any ofthe methods described in this application. In accordance with someimplementations, a non-transitory computer-readable storage mediumstores instructions that, when executed by a server system, cause theserver system to perform the operations of any of the methods describedin this application.

BRIEF DESCRIPTION OF THE DRAWINGS

For a better understanding of the various described implementations,reference should be made to the Detailed Description below, inconjunction with the following drawings. Like reference numerals referto corresponding parts throughout the figures and description.

FIG. 1A is a block diagram of an example network architecture fordetermining non-compliance patterns of clinicians according toillustrative implementations.

FIG. 1B is a block diagram of an example device management server incommunication with a medical device, and computing systems of ahealthcare facility, according to illustrative implementations.

FIG. 2 is a block diagram of an example server system from thearchitecture of FIG. 1 according to illustrative implementations.

FIG. 3 is a block diagram of an exemplary client device from thearchitecture of FIG. 1 according to illustrative implementations.

FIG. 4 is an example medical device which may be interacted with by aclinician within in a healthcare organization

FIG. 5 is a closer view of a portion of the medical device shown in FIG.4 .

FIG. 6 is a flow chart of an example process of registering a clinicianvia a medical device and granting or denying access to the medicaldevice, according to illustrative implementations.

FIG. 7 is a flow chart of an example process of determining aperformance score for one or more clinicians in healthcare facility,according to illustrative implementations.

FIG. 8 is a flow chart of an example process of alerting a medicationsystem and/or a pharmacy technician operating parameters ofadministering medication being overridden and determining whether one ormore administration parameters of a medication can be adjusted based onclinician interactions, according to illustrative implementations.

FIG. 9 is a flow chart of an example process of rating and identifyingone or more high performing external clinician staffing resourcecenters, according to illustrative implementations.

FIG. 10 is a flow chart of an example process of verifying and/oroptimizing a schedule for clinicians, according to illustrativeimplementations.

FIG. 11 is flow chart of an example process of identifying workflows andgenerating alerts and/or reminders for follow-up activity for clinicianswith low performance scores, according to illustrative implementations.

FIG. 12 is a flow chart of an example process of determiningnon-compliance patters of a clinician according to illustrativeimplementations.

In one or more implementations, not all of the depicted components ineach figure may be required, and one or more implementations may includeadditional components not shown in a figure. Variations in thearrangement and type of the components may be made without departingfrom the scope of the subject disclosure. Additional components,different components, or fewer components may be utilized within thescope of the subject disclosure.

DETAILED DESCRIPTION

The detailed description set forth below is intended as a description ofvarious configurations of the subject disclosure and is not intended torepresent the only configurations in which the subject disclosure may bepracticed. The appended drawings are incorporated herein and constitutea part of the detailed description. The detailed description includesspecific details for the purpose of providing a thorough understandingof the subject disclosure. However, it will be apparent to those skilledin the art that the subject disclosure may be practiced without thesespecific details. In some instances, structures and components are shownin block diagram form in order to avoid obscuring the concepts of thesubject disclosure. Like components are labeled with identical elementnumbers for ease of understanding.

The terminology used in the description of the various implementationsdescribed herein is for the purpose of describing particularimplementations only and is not intended to be limiting. As used in thedescription of the various described implementations and the appendedclaims, the singular forms “a,” “an,” and “the” are intended to includethe plural forms as well, unless the context clearly indicatesotherwise. It will also be understood that the term “and/or” as usedherein refers to and encompasses any and all possible combinations ofone or more of the associated listed terms. It will also be understoodthat, although the terms “first” and “second” are used herein todescribe various elements, these elements should not be limited by theseterms. These terms are used only to distinguish one element fromanother. It will be further understood that the terms “includes,”“including,” “comprises,” and/or “comprising” when used in thespecification, specify the presence of stated features, steps,operations, elements, and/or components, but do not preclude thepresence or addition of one or more other features, steps, operations,elements, components, and/or groups thereof. A clinician may include alicensed or unlicensed individual responsible for operating,maintaining, servicing, delivering, or otherwise interacting with amedical device in, by, or for a healthcare organization. As used herein,examples of a healthcare organization include hospitals, long-term carefacilities, nursing homes, out-patient treatment centers, store-frontretail treatment centers, pharmacies, community clinics, non-acute carefacilities, acute care facilities, and the like.

According to various aspects, the subject technology provides a means toidentify users, either by individual or role, so that clinical actionsand other actions may be associated with the users. In this regard,medical devices may be configured with a radio-frequency identification(RFID) tag readers to wirelessly receive data related to a clinician'sidentifying information stored in an RFID tag, such as a clinician'sbadge or identification card. The medical devices may be configured togrant or deny access to one or more protected functions of the medicaldevices and/or computing systems associated with a health care facilitybased on the received clinician's identifying information, a set ofpasscodes associated with one or more permissions, and/or one or morebadges of clinicians associated with one or more permissions. Protectedfunctions may include, but are not limited to, unlocking a medicaldevice, special clinical functions or workflows of the medical devices(e.g., infusion of restricted and/or classified drugs), access to biomedservice features (e.g., cleaning mode and/or features of medicaldevices, maintenance mode and/or features of medical devices, and thelike), and other similar functions of a medical device.

According to various implementations, the disclosed medical devices mayidentify new users associated with a health care facility withoutrequiring pre-registration at a central computing system, node, and/orserver. For example, in response to a clinician attempting to access aprotected function of a medical device, such as unlocking the medicaldevice, attempting to access a restricted function, and the like, themedical device may display a prompt on a display device associated withthe medical device to provide clinician identifying information, such asby scanning their badge. The medical device may be configured todetermine whether the received clinician identifying information existsin one or more data storage units associated with the medical device. Ifthe medical device determines that the clinician's identifyinginformation does not exist, then the medical device may display a prompton the display device associated with the medical device to enter apasscode of the clinician. In response to determining that the enteredpasscode is valid, the medical device may identify permissionsassociated with the passcode and based on the associated permissions,the medical device may grant and/or deny access to the function to theclinician. In some implementations, the use of passcodes allows aclinician to access one or more functions of a medical device withoutscanning a badge and/or if the clinician is without a badge.

The medical device may transmit a message to the device managementserver identifying the badge information received from the clinician andthe associated permissions. The device management server may beconfigured to automatically store the badge information in associationwith the permissions in one or more data storage units associated withthe device management server and/or update a master list of clinicianbadges and associated permissions. The device management server mayautomatically transmit new badge information and associated permissionsto other medical devices of the healthcare facility.

The subject technology may also include a device management serverconfigured to identify and track interactions of clinicians (e.g.,nurses) with medical devices in a healthcare organization (e.g.,hospital) and, based on the clinicians' interactions with the medicaldevices, the device management server may determine a number of timeswhen a medication is administered outside of a predetermined medicationadministration parameter value (e.g., dosage). If the number satisfies athreshold, the device management server may add the medication to a setof medications that are administered outside of predetermined drugadministration parameter values. In some implementations, the devicemanagement server may be configured to provide one or more alerts to auser (e.g., pharmacist, pharmacy technician, and the like) indicatingthe set of medications that are administered outside of predetermineddrug administration parameter values. In this regard, in someimplementations, the device management server may provide and/orindicate corresponding entries of the set of medications in a druglibrary of a drug management system of the healthcare organization. Insome implementations, the device management server may be configured todetermine changes to the respective entries of the set of medicationsbased on data related to administration of a medication by theclinicians (e.g., a dosage at which a medication is administered).

In some implementations, the device management server may generate ascore for one or more clinicians based on interactions of clinician withthe medical device, and schedule the clinicians into different shiftsbased on the scores of the clinicians. In some implementations, thedevice management server may be configured to schedule shifts ofclinicians to include a predetermined percentage or ratio of clinicianswith high scores and clinicians with lower scores. In someimplementations, for one or more low scoring clinicians that arescheduled in a shift, the device management server may scheduleclinicians assigned as mentors to the low scoring clinicians in thatsame shift. In some implementations, a healthcare organization maytemporarily staff one or more clinicians from various clinician staffingagencies, and, based on the clinicians' scores, the device managementserver may be configured to request clinicians from the clinicianstaffing agency associated with a majority of the clinicians with highscores. In some implementations, the device management server maygenerate and/or update a score for a clinician based on the interactionsof the clinician with different medical devices.

In some implementations, for clinicians with low scores, the devicemanagement server may be configured to provide one or more reminders orfollow-up steps that the clinician should perform next. Examples of suchsteps may include, but are not limited to, checking for device settings,checking vital signs, and the like. In some implementations, the devicemanagement server may display one or more steps related to a procedure(e.g., medication administration procedure) on a display deviceassociated with the medical device while the clinician is performing theprocedure using the medical device. Additional details of the subjecttechnology are described herein with reference to FIGS. 1-12 .

FIG. 1A is a block diagram of a network architecture 100 in accordancewith some implementations of the subject technology.

The network architecture 100 includes one or more medical devices 104-1,104-2, . . . , 104-n, collectively referred to herein as medical devices104. The one or more medical devices 104 may be communicatively coupledto a device management server 108 and/or one or more computing systemsof the healthcare facility 110-1, 110-2, . . . , 110-m, collectivelyreferred to herein as computing systems 110, by one or morecommunication networks 106. Examples of the one or more communicationnetworks include, but are not limited to, an intranet, the Internet,cellular telephone networks, mobile data networks, wide area networks,local area networks, metropolitan area networks, and the like. In someimplementations, the one or more communication networks 106 include apublic communication network (e.g., the Internet and/or a cellular datanetwork), a private communications network (e.g., a private LAN orleased lines), or a combination of such communication networks. Thedevice management server 108 may be configured to communicate with themedical devices 104 and/or the computing systems 110.

The device management server 108 may be configured to receive and/ortransfer clinician related data from and/or to the medical devices 104and/or the computing systems 110. Examples of clinician related datainclude, but are not limited to, clinician identifiers, clinicianbiographical information, information related to clinician trainingplans, and the like.

In some implementations, the device management server 108 may be asingle computing device such as a computer server, while in otherimplementations, the device management server 108 is implemented bymultiple computing devices working together to perform the actions of aserver system (e.g., cloud computing). Additional details of the devicemanagement server 108 are described herein and with reference to FIG. 2.

The medical devices 104 may include one or more input devices (shown inFIG. 3 ) configured to receive inputs to the medical devices 104. Theclinicians, such as users 102-1, 102-2, . . . , 102-n, collectivelyreferred to herein as users 102, may interact with the one or moremedical devices 104 via the one or more input devices. The users 102 mayutilize the medical devices 104 to access the device management server108 and/or computing systems 110 to participate in correspondingservices provided by the device management server 108 and/or computingsystems 110.

Turning now to FIG. 1B, there is shown a block diagram of a devicemanagement server 108 in communication with a medical device 104, andcomputing systems 110. As described previously, device management server108 may communicate with medical device 104 over network architecture100. In some implementations, as depicted in FIG. 4 , the medical device104 may include a programming module 60 configured to be connected toone or more functional modules.

The device management server 108 may be configured to receive, from acomputing system 110, data related to one or more badges and/orpasscodes of clinicians, and the permissions for one or more functionsof one or more medical devices 104 associated with the badges and/orpasscodes, as shown in FIG. 1B. In some implementations, data related toa badge and/or passcode of a clinician and the associated permissionsmay be collected via a computing system 110 of the healthcare facilityduring an onboarding process of adding the clinician to one or moreadministration systems (e.g., employee database, and the like) of thehealthcare facility. The device management server 108 may be configuredto receive configuration data and/or firmware for one or more medicaldevices 104 communicatively coupled with the device management server108, as shown in FIG. 1B. The configuration data and/or firmware may bereceived from one or more other computing systems 110 of the healthcarefacility.

The device management server 108 may be configured to transmit theconfiguration data and/or firmware, the data related to the one or morebadges and/or passcodes and the associated permissions to the one ormore medical devices 104 communicatively coupled with the devicemanagement server 108, as shown in FIG. 1B. The data related to the oneor more badges may be associated with clinician identifying informationof the one or more clinicians. In some implementations, clinicianidentifying information may be a unique identifier associated withand/or configured to identify a clinician, such as an employeeidentifier, a badge identifier, an identifier associated with theclinician in another administration system (e.g., an EMR system) of ahealth facility, and the like.

The one or more medical devices 104 may be configured to determinewhether clinician identifying information provided to the medicaldevices (e.g., by a clinician scanning a badge using the RFID reader ofthe medical device), and/or passcodes received from a user of themedical device are valid based on the received data related to the oneor more badges and/or passcodes. The medical devices 104 may beconfigured to grant or deny access to one or more functions (e.g.,unlocking a medical device, accessing a restricted function of a medicaldevice, and the like) of the medical devices based on the received datarelated to the permissions associated with the one or more badges and/orpasscodes. For any clinician identifying information that is not foundin the received data, the medical devices 104 may be configured toregister the associated clinician and transmit the new clinicianidentifying information to the device management server 108. The devicemanagement server 108 may transmit the clinician identifying informationalong with its associated permissions to other medical devices 104 ofthe healthcare facility. Additional details of determining whether aclinician's identifying information is valid and granting access to oneor more functions of a medical device, and registering a clinician via amedical device 104 are described herein with reference to FIG. 6 .

A medical device 104 may be configured to associate a clinician'sinteractions with the medical device with the received clinician'sidentifying information (e.g., received badge information) and transmitthe data related to the interactions to the device management server108, as shown in FIG. 1B. The device management sever 108 may beconfigured to determine a performance score for the clinicians based onthe interactions data received from the medical devices 104, and thedevice management server 108 may be configured to transmit the datarelated to the performance scores and corresponding clinicianidentifying information (e.g., badge information of a clinician,passcodes of clinicians, user identifiers of clinicians) to a computingsystem 110 of the healthcare facility to allow the computing system 110and/or a user of the computing system 110 to generate reports, such asreports related to clinician performance at the health care facility, asshown in FIG. 1B. The device management server 108 may be configured todisable and/or lock one or more functions of a medical device based onthe determined performance scores. Additional details of generatingperformance scores for clinicians and disabling and/or locking one ormore functions of a medical device are described herein with referenceto FIGS. 7-11 .

Turning now to FIG. 2 , there is shown a block diagram depicting adevice management server 108 in accordance with some implementations.The device management server 108 typically includes one or moreprocessing units (processors or cores) 202, one or more network or othercommunications interfaces 204, memory 206, and one or more communicationbuses 208 for interconnecting these components. The communication buses208 optionally include circuitry (sometimes called a chipset) thatinterconnects and controls communications between system components. Insome implementations, the device management server 108 may include adisplay device 212. In some implementations, the device managementserver 108 may include input devices such as a keyboard, a mouse, atrackpad, and/or input buttons. In some implementations, the displaydevice 212 may include a touch-sensitive surface, in which case thedisplay is a touch-sensitive display.

The memory 206 may be a high-speed random-access memory, such as DRAM,SRAM, DDR RAM, or other random-access solid-state memory devices, andmay include non-volatile memory, such as one or more magnetic diskstorage devices, optical disk storage devices, flash memory devices,and/or other non-volatile solid-state storage devices. In someimplementations, the memory 206 includes one or more storage devicesremotely located from the processor(s) 202. The memory 206, oralternatively the non-volatile memory device(s) within the memory 206,includes a non-transitory computer-readable storage medium. In someimplementations, the memory 206 or the computer-readable storage mediumof the memory 206 stores programs, modules, and/or data structures thatmay be used for the performing one or more operations of the devicemanagement server 108. For example, the memory 206 may include programs,modules, and/or data structures for an operating system 226, a networkcommunication module 228, a clinician information module 230, aclinician tracking module 232, a clinician scoring module 234, aclinician training plan module 235, a security module 236, and an accessdevice module 238.

In some implementations, the operating system 226 module may includeprocedures for handling various basic system services and for performinghardware dependent tasks. The network communication module 228 may beconfigured for connecting the device management server 108 to othercomputing devices via the one or more communication network interfaces204 (wired or wireless) and one or more communication networks 106. Theclinician information module 230 may be configured to store data relatedto clinicians including, but not limited to, clinician identifiers,clinician biographical information, current compliance scores of theclinicians, and the like. The clinician tracking module 232 may beconfigured to track information related to interactions of clinicianswith the medical devices 104. The clinician tracking module 232 may beconfigured track interactions of clinicians over a career of aclinician. The clinician tracking module 232 may be configured to groupand/or categorize the interactions of the clinician into one or moregroups and/or categories. Additional details of the grouping and/orcategorizing the interactions are described herein with reference toFIG. 6 .

The clinician scoring module 234 may be configured to generate a scorefor a clinician based on determining whether one or more interactionsare compliant. In some implementations, if the one or more interactionsare compliant, then the clinician scoring module 234 may increase thescore, and if the one or more interactions are non-compliant, then theclinician scoring module 234 may decrease the score. In someimplementations, the clinician scoring module 234 may be configured togenerate and/or maintain a score for each group and/or category ofinteractions. The access module 238 may be configured to grant, deny,and/or modify access to the device management server 108 and/or one orother computing systems or devices communicatively coupled to the devicemanagement server 108.

The clinician training plan module 235 may be configured to determinewhether one or more interactions are compliant and generate and/orupdate a compliance score based on whether the one or more interactionsare compliant. In some implementations, if the one or more interactionsare compliant, then the clinician training plan module 235 may increasethe compliance score, and if the one or more interactions arenon-compliant, then the clinician training plan module 235 may decreasethe compliance score. The clinician training plan module 235 may beconfigured to generate a training plan based on the compliance score. Insome implementations, the clinician training plan module 235 may beconfigured to generate and/or maintain a compliance score for each groupand/or category of interactions, and may generate a training plan forthe group and/or category of interactions with a compliance score thatsatisfies a threshold training plan compliance score. The access module238 may be configured to grant, deny, and/or modify access to the serversystem 108 and/or one or other computing systems or devicescommunicatively coupled to the server system 108.

Turning now to FIG. 3 , there is shown a block diagram depicting amedical device 104. A medical device 104 may include one or moreprocessors 302, one or more network or communications interfaces 304,memory 306, one or more communication buses 308, a user interface unit310, transmitter devices 322, and sensor devices 323. The one or moreprocessors 302, the one or more network or communication interfaces 304,memory 306, and the user interface unit 310 may be configured tocommunicate with one another via the one or more communication buses308. In some implementations, the communication buses 308 may includecircuitry (sometimes called a chipset) that interconnects and controlscommunications between components of the medical device 104. In someimplementations, the medical device 104 may include an image/videocapture device 324, such as a camera.

The user interface unit 310 may include a display 312, one or more inputdevices 316, such as a keyboard or a mouse, one or more audio outputdevices 318, and/or one or more audio input devices 320. In someimplementations, the display 312 may include a touch sensitive displayor surface 314, which is configured to receive inputs from a user 102.The one or more audio output devices 318 may include, but are notlimited to, speakers, interfaces configured to transfer audio relateddata to a device configured to project audio, and the like. The one ormore input devices 320 may include, but are not limited to, microphones,interfaces configured to receive audio related data from a deviceconfigured to receive audio.

The memory 306 includes high-speed random-access memory, such as DRAM,SRAM, DDR RAM or other random-access solid-state memory devices; and mayinclude non-volatile memory, such as one or more magnetic disk storagedevices, optical disk storage devices, flash memory devices, or othernon-volatile solid-state storage devices. In some implementations, thememory 306 includes one or more storage devices remotely located fromthe processor(s) 302. The memory 306, or alternatively the non-volatilememory device(s) within the memory 306, includes a non-transitorycomputer-readable storage medium. In some implementations, the memory306 or the computer-readable storage medium of the memory 306 stores theprograms, modules, and data structures that may be used for performingoperations of the medical device 104 and for performing techniquesdescribed herein for identifying non-compliance patterns of interactionswith the medical devices 104. The memory 306 may include an operatingsystem 326, a network communication module 328, an image/video capturemodule 330, an audio input/output module 332, a clinician informationmodule 334, and the like.

The operating system 326 may be configured to perform procedures ofexecution of various system services of the medical device 104,including, but not limited to, hardware, and software dependent tasks.The network communication module 328 may be configured to executeinstructions to connect the medical device 104 to one or more othercomputing devices, such as the device management server 108, computingsystems 110, and the like, via the one or more communication interfaces304 and communication networks, such as the communication network 106.The image/video capture module 330 may be configured to executeinstructions to capture images or a continuous stream of images. Theaudio input module 332 may be configured process received input data andtransmit instructions and/or related data to one or more othercomponents of the medical device 104. The access module 338 may beconfigured grant, deny, and/or modify access to the medical device 104.For example, the access module 338 may be configured to grant or denyaccess to the medical device 104 based on received login credentials forthe medical device 104.

The above identified modules and applications may correspond to a set ofexecutable instructions for performing one or more functions asdescribed above and/or in the methods described in this application(e.g., the computer-implemented methods and other information processingmethods described herein). One or more of the modules may be implementedas a specific hardware device with the appropriate input and outputsignal paths. The modules may be combined or otherwise re-arranged invarious implementations. In some implementations, the memory 206 and/orthe memory 306 store a subset of the modules and data structuresidentified above. In some implementations, the memory 206 and/or thememory 306 stores additional modules and data structures not describedabove. In some implementations, processors 302 may be configured toexecute the above identified modules for performing the one or moreabove-described functions and/or techniques FIG. 4 is an example medicaldevice which may be interacted with by a clinician within in ahealthcare organization. The medical device 104 shown in FIG. 4 mayinclude a programming module 60 configured to be connected to one ormore functional modules, such as the four fluid infusion pumps 22, 24,26, and 28 each of which is in operative engagement with a respectivefluid administration set 30, 32, 34, and 36. Fluid supplies 38, 40, 42,and 44, which may take various forms but in this case are shown asbottles, are inverted and suspended above the pumps. Fluid supplies mayalso take the form of bags or other types of containers. Both themedical device 104 and the fluid supplies 38, 40, 42, and 44 are mountedto a roller stand or pole 46. The specific fluid supplies as well astheir orientation (e.g., mount location, mount height, mounting type,etc.) within the care area may be generate one or more interactionrecords. The interaction record for a set for example may be generatedin part by detecting a scannable code associated with the set prior touse. Once scanned, the interaction record may be recorded for use asdescribed herein.

As shown in the example implementation of FIG. 4 , each administrationset 30, 32, 34, and 36 is connected between a respective fluid supply38, 40, 42, and 44 and the same patient 48 so that the patient mayreceive the fluids in all the fluid supplies. The administration set maybe identified either actively by, for example, scanning by a clinicianor passively by, for example, wireless or optical detection of theadministration set. As with the fluid supply, once identified, aninteraction record may be generated identifying the administration setand one or more of the clinician, programming module, pump,administration set positioning (e.g., administration location (e.g.,left forearm, right upper-arm, etc.).

A separate infusion pump 22, 24, 26, and 28 may be used to infuse eachof the fluids of the fluid supplies into the patient. The infusion pumpsare flow control devices that will act on the respective tube or fluidconduit of the fluid administration set to move the fluid from the fluidsupply through the conduit to the patient 48. Because individual pumpsare used, each can be individually set to the pumping or operatingparameters required for infusing the particular medical fluid from therespective fluid supply into the patient at the particular rateprescribed for that fluid by the clinician. The activities performed bythe pump or clinician to infuse the particular medical fluid may beassociated with one or interaction which may be recorded and processedas described.

Typically, medical fluid administration sets have more parts than areshown in FIG. 4 . Many have check valves, drip chambers, valved ports,connectors, and other devices well known to those skilled in the art.These other devices have not been included in the drawings so as topreserve clarity of illustration.

FIG. 5 is a closer view of a portion of the medical device shown in FIG.4 . FIG. 5 shows two of the fluid infusion pumps mounted at either sideof a programming module, and the displays and control keys of each, withthe programming module being capable of programming both infusion pumps.The pump 22 includes a door 50 and a handle 52 that operates to lock thedoor in a closed position for operation and to unlock and open the doorfor access to the internal pumping and sensing mechanisms and to loadadministration sets for the pump. When the door 50 is open, the tube canbe connected with the pump 22. When the door 50 is closed, the tube isbrought into operating engagement with the pumping mechanism, theupstream and downstream pressure sensors, and the other equipment of thepump. In some implementations, a display 54, such as an LED display, maybe located in plain view on the door, and may be used to visuallycommunicate various information relevant to the pump 22, such as alertindications (e.g., alarm messages). Control keys 56 exist forprogramming and controlling operations of the infusion pump as desired.In some implementations, the control keys may be omitted and bepresented as interactive elements on the display 54 (e.g., touchscreendisplay). The infusion pump 24 also includes audio alarm equipment inthe form of a speaker (not shown).

In the example shown in FIG. 4 , a programming module 60 is attached tothe left side of the infusion pump 24. Other devices or modules,including another infusion pump, may be attached to the right side ofthe infusion pump 24, as shown in FIG. 4 . In such a system, eachattached pump represents a pump channel of the overall medical device20. In some implementations, the programming module is used to providean interface between the infusion pump 24 and external devices as wellas to provide most of the operator interface for the infusion pump 24.Attention is directed to U.S. Pat. No. 5,713,856 entitled “ModularPatient Care System” to Eggers et al. incorporated herein by referencein which the programming module is described as an advanced interfaceunit.

Returning to FIG. 5 , the programming module 60 includes a display 62for visually communicating various information, such as the operatingparameters of the pump 24 and alert indications and alarm messages. Theprogramming module 60 may also include a speaker to provide audiblealarms. The programming module 60 may also include one or more inputdevices, such as control keys 64 or a bar code scanner (not shown) forscanning information relating to the infusion, the patient, theclinician, or other. In some implementations, the display 62 may beimplemented as a touchscreen display (e.g., display 312). In suchimplementations, the control keys 64 may be omitted or reduced in numberby providing corresponding interactive elements via a graphical userinterface presented via the display 62. The programming module 60 mayinclude a communications system (not shown) with which the programmingmodule 60 may communicate with external equipment such as a medicalfacility server or other computer and with a portable processor, such asa handheld communication device or a laptop-type of computer, or otherinformation device that a clinician may have to transfer information aswell as to download drug libraries to a programming module 60 or pump.The communication module may be used to transfer access and interactioninformation for clinicians encountering the programming module or devicecoupled therewith (e.g., pump 22 or bar code scanner). Thecommunications system may include one or more of a radio frequency (RF)system such as an RFID system, an optical system such as infrared, aBLUETOOTH™ system, or other wired or wireless system. The bar codescanner and communications system may alternatively be includedintegrally with the infusion pump 24, such as in cases where aprogramming module is not used, or in addition to one with theprogramming module 60. Further, information input devices need not behard-wired to medical instruments, information may be transferredthrough a wireless connection as well.

The example shown in FIG. 5 includes a second pump module 26 connectedto the programming module 60. As shown in FIG. 4 , more pump modules maybe connected. Additionally, other types of modules may be connected tothe pump modules or to the programming module such as syringe pumpmodule, oximeter reader module, patient controlled analgesic module, orthe like. Each module may generate interaction records of one or moreinteraction types. The interaction record may include an identifier ofthe module or device with which the interaction was conducted. Theidentifier may include a device type identifier, a model or seriesidentifier, or a unique identifier for a specific device.

Turning now to FIG. 6 , there is shown a flowchart illustrating aprocess of registering a clinician via a medical device and granting ordenying access to the medical device. For the purpose of illustrating aclear example, components of the network architecture 100, shown anddescribed with reference to FIG. 1A, components shown and described withreference to FIG. 1B, components of the device management server 108,shown and described with reference to FIG. 2 , and components of themedical devices 104, shown and described with reference to FIGS. 3, 4,and 5 may be used to describe the process of registering a clinician viaa medical device and granting or denying access to the medical device.

The method 600 includes transmitting, by a processor 202 of the devicemanagement server 108, data related to clinician identifying informationand/or passcodes associated with one or more clinicians to a medicaldevice 104 (block 601). As described above, examples of clinicianidentifying information of a clinician may include, but are not limitedto, a badge identifier, a passcode, identifiers in different healthand/or administration systems (e.g., EMR system), and the likeassociated with the clinician. As described above, the device managementserver 108 may store clinician identifying information and/or passcodesof one or more clinicians with permissions for one or more functions ofa medical device. The device management server 108 may transmitpermissions data associated with the passcodes to the medical device104. The medical device 104 displays a prompt on a display device for auser to provide clinician identifying information (block 602). Forexample, the processor 302 of the medical device 104 may display aprompt on a display device associated with the medical device 104 (e.g.,display 62) for the user to scan a badge of the user near an RFID readerof the medical device. The medical device 104 receives the clinicianidentifying information (block 603). The processor 302 of the medicaldevice 104 may receive, via the RFID reader of the medical device 104,clinician identifying information from an RFID tag (e.g., a badge oridentification card of a clinician).

The medical device 104 may be configured to determine whether thereceived clinician identifying information exists (block 604). In someimplementations the medical device 104 may determine whether thereceived clinician identifying information exists by providing theclinician identifying information to the device management server 108and receive confirmation that the clinician associated with theidentifying information is valid, active, and/or in good standing (e.g.,clinician is not suspended). As described above, for example, withreference to FIG. 1B, the device management server 108 may receive datarelated to clinician identifying information of various clinicians, suchas data related to badge identifiers (“badge identifier data”),passcodes (“passcode data”), clinician identifiers in differentadministration and/or health systems (e.g., an EMR system), and thelike, of the various clinicians, along with permissions associated withthe clinician identifying information for different clinicians.

For example, the medical device 104 may receive a badge identifier ofthe clinician as the clinician identifying information and may determinewhether the received badge identifier exists by providing the badgeidentifier to the device management server 108 (or medical device 104).The device management server 108 may search for the badge identifier inthe badge identifier data stored in one or more data storage unitsassociated with the device management server 108, and provide aconfirmation message to the medical device 104 indicating whether thebadge identifier is valid, active and/or in good standing based on thesearch results.

In some implementations, the device management server 108, in responseto determining that the clinician identifying information received fromthe medical device 104 is valid, active, and/or in good standing, may beconfigured to identify the permissions associated with it and transmitthem to the medical device 104 to ensure that the medical device 104comprises the most current permissions data. The medical device 104 maybe configured to update stored permissions data for a clinician with thepermissions data most recently received from the device managementserver 108.

If the medical device 104 determines that the received clinicianidentifying information exists (YES' at block 604), then the method 600proceeds to block 605. The medical device 104 applies the one or morepermissions associated with the clinician identifying information andtransmits a message to the device management server 108 indicatingwhether the clinician is granted access to the medical device 104 (block605). As described above, in some implementations, permissionsassociated with clinician identifying information may indicate whetherthe clinician has permission to unlock the device, whether thepermission to unlock the device was changed based on the clinician's lowperformance score, whether the clinician requires a second clinician toalso provide their clinician identifying information to grant access tothe device, whether the clinician has permissions to access certainrestricted functions, and the like. If the medical device 104 determinesthat the received clinician identifying information does not exist (NO′at block 604), then the method 600 proceeds to block 606.

The processor 302 of the medical device 104 displays a prompt for theclinician to enter a passcode on a display device associated with themedical device 104 (block 606). The processor 302 may receive a passcodeprovided by the clinician, and the processor 302 determines whether thepasscode is valid (block 607). The processor 302 may be configured todetermine whether the passcode is valid based on whether the passcode isfound in the list of passcodes received from the device managementserver 108. For example, if the processor 302 is unable to find thepasscode in the list of received passcodes, then the processor 302determines that the passcode is not valid. If the processor 302determines that the passcode is not valid, then the method 600 proceedsto block 608. The processor 302 electronically prevents the clinicianfrom using the medical device (block 608). The processor 302 may beconfigured to electronically prevent the clinician from using themedical device 104 by preventing the clinician to log into the medicaldevice 104, denying access to the functions of the medical device 104and/or module(s) connected to the medical device 104 to the clinician,electronically locking the medical device 104, and/or electronicallydisabling the medical device 104. In some implementations, the processor302 may disable functions of any modules connected to the medical device104. For example, the processor 302 may stop or prevent initiation ofany infusion of medication to a patient via a pump module connected tothe medical device 104 after the medical device 104 is electronicallylocked out and/or electronically disabled.

The processor 302 may cause the medical device 104 to be in anelectronically locked and/or disabled state until the medical device 104receives clinician identifying information associated with a permissionsfor one or more functions of the medical device 104. For example, theprocessor 302 may place the medical device 104 in an electronicallylocked and/or disabled state until the processor 302 receives badgeinformation and/or passcode of a clinician with permission to unlock themedical device 104 or is granted electronic access to use the medicaldevice 104. Returning to block 607, if the processor 302 determines thatthe passcode is valid (e.g., identifies the passcode in the list ofreceived passcodes), then the method 600 proceeds to block 609. Theprocessor 302 applies the permissions associated with the passcode(block 609). The processor 302 grants access to the medical device 104based on the permissions associated with the passcode. The processor 302may associate the permissions associated with the passcode and thepasscode to the clinician identifying information (e.g., badgeidentifier of the clinician) received in block 604 and transmits theclinician identifying information, the associated passcode, and theassociated permissions to the device management server 108 (block 610).The processor 202 of the device management server 108 transmits the newclinician identifying information along with associated passcode andpermissions to the other medical devices 104 (block 611). In someimplementations, the processor 202 may transmit the new clinicianidentifying information along with associated passcode and permissionsto other medical devices 104 in multiple healthcare facilities of ahealthcare organization. The processor 202 may store the new clinicianidentifying information in association with the associated passcode andpermissions in one or more data storage units associated with the devicemanagement server 108.

With the device management server 108 transmitting the new clinicianidentifying information along with associated permissions to othermedical devices 104 of the healthcare facility and/or organization, thedevice management server 108 ensures that the medical devices 104 areupdated with the most current clinician identifying information andassociated permissions. Thus, a clinician, registered by one medicaldevice 104, is recognized at other medical devices 104 without having toregister at the other medical devices 104. The permissions grantedand/or updated for the clinician are also applied at the other medicaldevices 104, thus providing the similar access and/or functionality tothe clinician. For example, if a clinician who is registered by a firstmedical device 104, provides his/her clinician identifying informationto a second medical device 104, such as by scanning his/her badge at asecond medical device 104, then the second medical 104 may determinethat the clinician identifying information exists, is valid, active,and/or in good standing based on the corresponding clinician identifyinginformation received from the device management server 108, and applythe permissions associated with the clinician identifying informationbased on the corresponding permissions data received from the devicemanagement server 108. The second medical device 104 may be configuredto utilize the techniques described above with reference to blocks 604and 605 to determine whether the clinician identifying informationexists, is valid, active, and/or in good standing, and apply theassociated permissions.

In some implementations, operating parameters and/or preferences may beassociated with one or more clinicians (e.g., associated withcorresponding clinician identifying information). Examples of theoperating parameters and/or preferences may include, but are not limitedto, modifications made by the clinician to user interfaces and/orworkflows associated with one or more medications frequentlyadministered by the clinician, and the like. In such implementations,the device management server 108 may provide the operating parametersassociated with the clinician to the medical devices 104, and theprocessors 302 of the medical devices 104 may be configured to updatedisplay devices associated with the medical devices 104 based on theassociated operating parameters. For example, for a medication that isidentified as a frequently administered medication, the processor 302may modify an associated user interface based on the one or moreoperating parameters and/or preferences indicating the modifications tothe user interface previously made by the clinician while administeringthe medication.

As described above, in some implementations, a medical device 104 may beconfigured to receive an identifier of a clinician in a patient relatedsystem (e.g., an EMR system) of the healthcare facility. The processor302 may be configured to determine whether that identifier of theclinician (e.g., identifier of the clinician in the EMR) exists in oneor more data storage units associated with the medical device 104. Ifthe identifier exists, then processor 302 may apply the permissionsassociated with the medical device 104. If the processor 302 determinesthat the identifier does not exist, then the processor 302 may promptthe clinician for other clinician identifying information (e.g.,scanning a badge of the clinician) and/or passcodes of the clinician todetermine whether to grant access to the medical device 104. If theprocessor 302 determines that valid clinician identifying informationand/or passcodes were provided, then the processor 302 may apply theassociated permissions and transmit information related to theidentifier of the clinician in the patient related system to the devicemanagement server 108, and the device management server 108 mayautomatically update other medical devices 104 with the identifier ofthe clinician in the patient related system and associated permissions,passcodes, and/or other clinician identifying information.

With the other medical devices 104 receiving the identifier of theclinician in the patient related system and associated permissions, theclinician is now recognized by the other medical devices 104. Therefore,permissions associated with an identifier of the clinician in thepatient related system at one medical device 104 may be applied byanother medical device 104 that receives the identifier of the clinicianin the patient related system. For example, if a patient associated witha second medical device 104 is under the care of the clinician, and thesecond medical device 104 receives the corresponding identifier of theclinician in the EMR system, then the second medical device 104 may beconfigured to apply the permissions associated with the identifier ofthe clinician, without registering the identifier of the clinician inthe EMR system at the second medical device 104.

Turning now to FIG. 7 , there is shown a flowchart illustrating aprocess of determining a performance score for one or more clinicians ina healthcare facility. For the purpose of illustrating a clear example,components of the network architecture 100, shown and described withreference to FIG. 1A, components shown and described with reference toFIG. 1B, components of the device management server 108, shown anddescribed with reference to FIG. 2 , and components of the medicaldevices 104, shown and described with reference to FIGS. 3, 4, and 5 maybe used to describe the process of determining a performance score forone or more clinicians in a healthcare facility.

The method 700 includes receiving, by the processor 202 of the devicemanagement server 108, information related to an identifier of aclinician at a medical device 104 (block 701). As described above, theprocessor 202 may receive information related to an identifier of aclinician in response to the clinician attempting to access a medicaldevice 104 (e.g., by scanning his or her identification card at themedical device 104). The processor 202 receives information related tothe one or more interactions of the clinician with the medical device(block 702). As described above, examples of the information related tointeractions of the clinician with a medical device 104 include, but arenot limited to, administration of two or more medications concurrently,medication-to-medication interactions of concurrently administeredmedications, volume of a medication administered, dosage of a medicationadministered, care area in which the clinician interacted with themedical device, class of medication administered, type of patients towhom medication administered, response time to one or more alarmsgenerated by a medical device, medical route (e.g., intravenously,subcutaneous, arterial, epidural, and the like) of administering amedication, type of set (e.g., tubing, syringe, or connections) for anadministration of fluid or medication, duration of use of a set for anadministration, type of tubing and connections used during infusion,tubing change (e.g., tubing changed in 72 hours, 96 hours, and thelike), administration of a certain medication to a patient, volumetricrate of a medication administered (e.g., administering a medication at arate of 75 milliliters per hour), and other similar information. Theinteractions may also be associated with a sequence to determine whichinteractions occurred and an order or timing for the interactions thatoccurred.

The processor 202 generates and/or updates a performance score for theclinician based on the one or more interactions of the clinician withthe medical device (block 703). The device management server 108 may beconfigured to store a performance score of a clinician in associationwith the clinician (e.g., in association with the identifier of theclinician) in one or more data storage systems associated with thedevice management server 108. In some implementations, the processor 202may be configured to determine whether a performance score is availablefor the clinician by searching through one or more data storage systemsassociated with the device management server 108. If the processor 202retrieves a performance score associated with the clinician, then theprocessor 202 updates the performance score based on the receivedinformation related to the one or more interactions of the clinician. Ifa performance score is not retrieved, then the processor 202 generates aperformance score based on the received information related to the oneor more interactions of the clinician and stores the performance scorein association with the clinician in one or more data storage systemsassociated with the device management server 108.

The processor 202 may be configured to generate and/or update aperformance score based on whether an interaction of the clinician withthe medical device satisfies a set of rules associated with one or moreprocedures for treating a patient. Examples of the one or moreprocedures for treating a patient include, but are not limited to,administering a medication to the patient using the medical device,responding to an alarm generated by a medical device connected to thepatient, patient follow-up after administering certain medications,patient monitoring, and the like. Examples of a set of rules associatedwith a procedure may specify a predetermined volumetric rates, pressurerates, dosage, volume, and the like for one or more medications. In someimplementations, the set of rules may also specify one or more groups ofmedications that may be simultaneously or sequentially administered. Insome implementations, the set of rules may specify different volumetricrates, pressure rates, dosage rates, and the like for different types ofpatients (e.g., patients with a heart condition, obese patients,patients with one or more allergies, and the like). In someimplementations, the set of rules may further specify the differentmedical routes (e.g., intravenous, epidural, subcutaneous, otherparenteral routes, and the like) of administration via which amedication may be administered.

The processor 202 may determine whether the clinician's interactionswith the medical device for a procedure for treating a patient satisfy acorresponding set of rules based on comparing the received informationrelated to the one or more interactions and corresponding values and/orinteractions specified by the set of rules. For example, if theclinician administered two medications simultaneously and the set ofrules specify one or more sets and/or groups of medications that may besimultaneously administered, then the processor 202, may verify whetherboth medications are specified as part of a group or a set ofmedications that can be administered simultaneously. If the processor202 determines that both medications are not part of a group or set ofmedications that can be administered simultaneously, then the processor202 may determine that the clinician's interactions do not satisfy theset of rules for the procedure for administering the medication, andgenerates and/or adjusts (e.g., reduces) a performance score of theclinician to reflect the clinician's interactions. If the processor 202determines that both medications are part of a group or set ofmedications that can be administered simultaneously, then the processor202 may determine that the clinician's interactions satisfy the set ofrules and generates and/or adjusts (e.g., increases) a performance scoreof the clinician to reflect the clinician's interactions.

In some implementations, a performance score may be determined byidentifying the rules applicable to the interactions for a selectedperiod of time. The period of time may be provided as an input. In someimplementations, the period of time may be provided as an input via auser interface. In some implementations, the period of time may bespecified in a configuration parameter for the device management server108. The processor 202 may obtain the interactions for the subject(s)over the period of time. The processor 202 may then obtain theapplicable rules from the set of rules for that procedure. Thisfiltering can reduce the amount of resources needed to generate theperformance scores for the subject(s). Once the applicable rules areobtained, the processor 202 may then assess the interactions bycomparing an interaction with an applicable rule. An interaction recordmay include an interaction type. The interaction type may be used as akey for identifying relevant compliance rules by, for example, matchingan identifier for the interaction type to a value specified in or by arule for a procedure. The interaction record may also includeinteraction data identifying, for example, the volume programmed, therate programmed, or other clinician behavior for the interaction. Eachrule may contribute a value to a composite performance score.

The processor 202 may be configured to update a performance score by apredetermined adjustment amount. In some implementations, the processor202 may be configured to determine an amount based on how frequently theclinician's interactions were satisfied corresponding rules over apredetermined period of time. For example, if the clinician administersa medication at an incorrect dosage several times over a period of 30days, then the processor 202 may decrease the performance score by agreater amount each successive time.

The processor 202 may update and/or maintain the performance score overa career of the clinician by associating the performance score with theidentifier of the clinician. In some implementations, the performancescore of a clinician may be a cross-product performance score whichreflects the clinician performance scores across different medicaldevices products. For example, the processor 202 may update and/ormaintain device specific performance scores of a clinician, where eachdevice specific performance score may be associated with a differentmedical device product, and the device specific performance score may bebased on one or more clinician interactions with the medical deviceproduct. In such implementations, the processor 202 may generate,maintain, and/or update an aggregated performance score based on one ormore of the device specific performances scores.

The processor 202 determines whether the performance score of theclinician satisfies a threshold low performance score (block 704). Thethreshold low performance score may be a predetermined performance scorethat indicates that the clinician needs additional guidance and supportto satisfactorily complete one or more procedures in treating a patient.If the processor 202 determines that the performance score does notsatisfy the threshold low performance score (e.g., performance score isgreater than the threshold low performance score) (YES' at block 704),then the method 700 proceeds to block 707. The processor 202 determineswhether performance score satisfies a threshold high performance score(block 707).

If the processor 202 determines that the performance score does notsatisfy a threshold high performance score (e.g., less than the highperformance score) (NO′ at block 707), then the method 700 proceeds toblock 701. If the processor 202 determines that the performance scoresatisfies the threshold high performance score (e.g., equal to orgreater than the high performance score) (‘YES’ at block 707), then themethod 700 proceeds to block 708. The processor 202 adds the clinicianto a list of mentor clinicians (block 708). In some implementations,each clinician in the list of mentor clinicians may be associated with aperformance score that satisfies the threshold high performance score.The processor 202 may store the list of mentor clinicians in a datastructure in one or more data storage systems associated with the devicemanagement server 108. In some implementations, the processor 202 mayadd the clinician to the list of mentor clinicians by adding theidentifier of the clinician to the data structure comprising the list ofmentor clinicians.

At block 704, if the processor 202 determines that the performance scoresatisfies the threshold low performance score (e.g., the performancescore is equal to or less than the threshold low performance score)(‘YES’ at block 704), then the method 700 proceeds to block 705. Theprocessor 202 identifies a mentor clinician for the clinician (block705). In some implementations, the processor 202 identifies a mentorclinician associated with fewest clinicians. The processor 202associates the mentor clinician with the clinician (block 706). Theprocessor 202 stores the association of the mentor clinician with theclinician in a data storage system associated with the device managementserver 108.

The device management server 108 may be configured to utilize theperformance scores of the clinicians to improve efficiency andperformance of other systems of a health care facility that arecommunicatively coupled to the device management server 108. Forexample, in some scenarios, a health care facility may utilize externalclinician staffing resource centers for temporary or travelingclinicians that can assist the health care facility, and the devicemanagement server 108 may be configured to identify one or more highperforming external clinician staffing resource centers based on theperformance scores of the their clinicians.

Additional details of identifying one or more high performing externalclinician staffing resource centers are described herein with referenceto FIG. 9 . In another example, the device management server 108 may beconfigured to optimize scheduling of clinicians based on theirperformance scores and/or a scheduling criteria. Additional details ofan optimized scheduling of clinicians are described herein withreference to FIG. 10 . In yet another example, the device managementserver 108 may identify clinicians with low performance scores andgenerate alerts and/or reminders for a follow-up activity for theclinician to complete. Additional details of generating alerts and/orreminders for follow-up activity for clinicians with low performancescores are described with reference to FIG. 11 .

In some implementations, the processor 202 may be configured to identifya set of clinicians with performance scores that satisfy a highthreshold performance score for a threshold amount of time (e.g., anumber weeks, a consecutive number of months, and the like), as highlyregarded clinicians and associate a title (e.g., “Hall of Famer”,“M.V.P.”, and the like) and/or a graphical icon (e.g., a graphicalcrown, and the like) with the clinicians and may transmit theassociation of the titles and/or graphical icons with the clinicians tothe medical devices 104. For example, the processor 202 may beconfigured to identify a set of clinicians with performance scores thatsatisfy the high threshold performance score for a 5 consecutive monthsas “Hall of Fame” clinicians and associates the title “Hall of Famer”and a graphical crown icon with corresponding clinician identifyinginformation of the clinicians. In some implementations, a processor 302of a medical device 104 may be configured to determine whether aclinician requesting access to the medical device 104 is associated withany specific titles (e.g., “Hall of Famer”, “M.V.P.”, and the like)and/or graphical icons and display the associated titles and/orgraphical icons on a display device (e.g., near the name of theclinician) associated with the medical device 104.

In some implementations, the processor 202 may be configured todetermine one or more high performing care areas (e.g., intensive careunit, emergency room, ward, and the like) and/or one or more lowperforming care areas of a healthcare facility based on performancescores of clinicians associated with the care areas. In someimplementations, the processor 202 may be configured to display the oneor more high performing care areas on one or more display devicespositioned on one or more floors of the healthcare facility. In someimplementations, the processor 202 may be configured to generate andtransmit messages to the clinicians associated with the low performingcare areas indicating that their associated care area is a lowperforming care area. In some implementations, the processor 202 may beconfigured to identify a set of clinicians with low performance scoresfor a threshold period of time and/or low performing care areas with agroup and associate the set of clinicians and/or the care areas with agroup name (e.g., a “Wall of Shame” group name, and the like).

In some implementations, the device management sever 108 may beconfigured to transmit instructions to the medical devices 104 toelectronically lock out from the medical devices 104 and/or deny accessto access to one or more features of the medical devices 104toclinicians with performance scores satisfying the low performancethreshold score. In response to receiving the instructions, the medicaldevices 104 may be configured to not grant access to any functionality(e.g., unlocking the medical device 104) of the medical device to theclinician. In some implementations, the device management server 108 maybe configured to associate the clinicians with performance scoressatisfying the low performance threshold score with a second clinician(e.g., a mentor clinician) and require the second clinicians to alsoprovide their clinician identifying information in order for the medicaldevice 104 to grant access to the clinicians with low performancescores. In some implementations, the device management server 108 may beconfigured to compile training packages to address the low performancescores of the clinicians. In some implementations, the device managementserver 108 may be configured to determine effectiveness of trainingpackages based on changes to the performance scores of clinicians. Insome implementations, the device management server 108 may be configuredto cause additional safety alerts to be displayed on a display deviceassociated with a medical device and/or modify a workflow in the medicaldevice while a clinician with low performance score is interacting withthe medical device to reduce any safety risks. In some implementations,the processor 202 may cause a clinician with a low performance score tobe electronically locked out from the medical device 104 and/or denyaccess to one or more features of a functional module connected to amedical device 104 (e.g., an infusion pump connected to a medical device104) to prevent the clinician from initiating and/or interfering withadministration of medication. Additional details of electronicallylocking out clinicians from medical devices and/or denying access to oneor more features of medical devices, generating and/or compilingtraining packages, assessing effectiveness of the training, and/orrequiring a secondary clinician authorization to access a medical deviceand/or one or more functions of the medical device are described in U.S.Provisional Patent Application No. 62/865,906, which application isincorporated herein by reference.

Turning now to FIG. 8 , there is shown a flowchart illustrating aprocess of alerting a medication system and/or a pharmacy technician ofhealthcare facility of clinicians overriding operating parameters ofadministering medication and determining whether one or moreadministration parameters of a medication can be adjusted based on oneor more clinicians interactions with a medical device used foradministering the medication. For the purpose of illustrating a clearexample, components of the network architecture 100, shown and describedwith reference to FIG. 1A, components shown and described with referenceto FIG. 1B, components of the device management server 108, shown anddescribed with reference to FIG. 2, and components of the medicaldevices 104, shown and described with reference to FIGS. 3, 4, and 5 maybe used to describe the process of alerting a medication system and/or apharmacy technician of healthcare facility of clinicians overridingoperating parameters of administering medication and determining whetherone or more administration parameters of a medication can be adjustedbased on one or more clinicians interactions with a medical device usedfor administering the medication.

The method 800 includes receiving, by the processor 202 of the devicemanagement server 108, information related to an identifier of aclinician at a medical device 104 (block 801). The processor 202 mayreceive information related to an identifier of a clinician in responseto the clinician attempting to access a medical device 104. In someimplementations, the clinician may attempt to access a medical device104 by providing his or her access credentials to the medical device 104(e.g., scanning his or her identification card at the medical device104). A clinician's access credentials may be associated with and/orinclude a unique identifier of the clinician, and the medical device 104may be configured to transmit the unique identifier associated with theclinician to the device management server 108 in response tosuccessfully granting access to the clinician. Examples of a uniqueidentifier of a clinician include, but are not limited to, a useridentifier, an employee identifier, and the like.

The processor 202 identifies a predetermined care area of the healthcarefacility based on location information of the medical device (block802). The location of the medical device may be determined by way of aGPS locator system within the medical device, or by the medical devicetransmitting over or connecting with a particular WiFi transceiver at aknown location. Examples of care area include, but are not limited to,intensive care unit (ICU), ward, and the like. The processor 202receives information related to the one or more interactions of theclinician with the medical device (block 803). Examples of theinformation related to interactions of the clinician with a medicaldevice 104 include, but are not limited to, administration of a certainmedication to a patient, volumetric rate of a medication administered(e.g., administering a medication at a rate of 105 milliliter per hour),and the like. In some implementations, the processor 202 may group themedical device interactions of the clinician in a group associated withthe predetermined care area in which the medical device is located. Forexample, the processor 202 may group the interactions of the clinicianwith a medical device located in an intensive care unit in a groupassociated with the intensive care unit and may group interactions ofthe clinician with a different medical device located in a ward in agroup associated with the ward.

The processor 202 identifies a medication being administered to apatient using the medication device (block 804). In someimplementations, the processor 202 may identify the medication based onthe one or more interactions of the clinician with the medical device.For example, an interaction of the clinician with the medical device maybe to program a medication to be administered to the patient using themedical device, and the information related to the interaction mayindicate an identifier and/or name of the medication, and the processor202 may determine the medication being administered to the patient basedon the identifier and/or name of the medication indicated by theinformation related the interactions. In some implementations, theprocessor 202 may identify the medication being administered based onthe patient's record in an EMR system communicatively coupled to thedevice management server 108.

The processor 202 determines whether the medication is administeredoutside a predetermined value of an administration parameter of themedication (block 805). Examples of a medication's administrationparameters may include, but are not limited to, dosage of themedication, volumetric rate of a medication administered, administrationof two or more medications concurrently, medication-to-medicationinteractions of concurrently administered medications, volume of amedication administered, a list of medications with which the medicationmay be concurrently administered, volume of a medication administered,and the like. Predetermined values of a medication's administrationparameters may be stored in association with the medication in a datastorage system associated with a drug management system. Thepredetermined values of the medication's administration parameters maybe provided as inputs to the drug management system by a user of thedrug management system, such as a pharmacist. The device managementserver 108 may be communicatively coupled to the drug management system.In some implementations, the processor 202 may receive predeterminedvalues of one or more administration parameters of the medication fromthe medical device and/or the drug management system. In someimplementations, the processor 202 may be configured to query the drugmanagement system for predetermined values of one or more of themedication's administration parameters.

The processor 202 may determine one or more administered values of themedication by the clinician based on the received information related tothe one or more interactions of the clinician with the medical device.For example, the received information may indicate that the clinicianadministered the medication at a volumetric rate of the 100 millilitersper hour. The processor 202 may determine whether the medication isadministered outside of a predetermined administration parameter valuebased on a comparison of the administered value with a predeterminedvalue of a corresponding administration parameter. For example, theprocessor 202 may determine that the medication is administered outsideof a predetermined administration parameter value if a volumetric rateat which the medication is administered by the clinician is greater orlesser than the predetermined volumetric rate for that medication.

If the processor 202 determines that the medication is not administeredoutside a predetermined administration parameter value (‘NO’ at block805), then the method 800 proceeds to the block 801. If the processor202 determines that the medication is administered outside apredetermined administration parameter value (‘YES’ at block 805), thenthe method proceeds to block 806. The processor 202 updates a counter(block 806). The counter may be associated with the medication and/or anadministration parameter of the medication. The counter may beassociated with the predetermined care area. For example, the processor202 may maintain multiple counters for a single medication and/or anadministration parameter of the medication, where each counter may beassociated with a different predetermined care area of the healthcarefacility. The processor 202 may update the counter by increasing thecounter by a predetermined value (e.g., increasing the value by one) toindicate that the medication is administered outside of thepredetermined administration parameter value again.

The processor 202 determines whether the number of times the medicationis administered outside of the predetermined value of an administrationparameter satisfies a threshold value (block 807). The processor 202 maydetermine whether the threshold value is satisfied based on the value ofthe counter. If the threshold value is not satisfied (‘NO’ at block807), then the method 800 proceeds to block 801. In some implementationsthe processor 202 may update (e.g., decrease) a score associated withthe clinician to indicate that the clinician did not satisfactorilyfollow expected procedure for administering the medication. If theprocessor 202 determines that the threshold value is satisfied (‘YES’ atblock 807), then the method 800 proceeds to block 808. In someimplementations, if the processor 202 determines that the thresholdvalue is satisfied, the processor 202 may not negatively adjust theperformance score of the clinician.

The processor 202 transmits one or more alerts for the medication to auser of the drug management system (block 808). The processor 202 mayindicate a corresponding entry in the drug management system of themedication, and/or other information related to the medication'sadministration in the alert. For example, the processor 202 may includeinformation related to an identifier of the medication in the drugmanagement system, and the clinicians of the predetermined care areathat administered the medication outside of the predetermined values. Insome implementations, the processor 202 may add the medication to a listof medications that have been administered outside of one or morerespective predetermined values of their administration parameters athreshold number of times. The processor 202 may transmit an instructionto the drug management system to cause the drug management system todisplay a graphical icon on a display device associated with the drugmanagement system, where the graphical icon identifies the list ofmedications and indicates that these medications are administeredoutside of the predetermined values most often. In some implementations,the processor 202 may order the list of medications based on the numberof times the medication is administered outside a predetermined value(e.g., top 10 medication offenders), and include the ordered list in thealert. In some implementations, if the threshold number of times is notsatisfied, then the processor 202 may order a list of clinicians thatmost frequently administer the medication outside of the predeterminedparameters and include that list in the alert to cause that list to bedisplayed on a display device associated with the medication system.

In some implementations, the processor 202 may determine a new value toa predetermined value of an administration parameter of a medication inthe list. The processor 202 may determine the new value for theadministration parameter based on the values of the administrationparameter at which the medication is administered to the. For example,if a medication is administered at a volumetric rate that is outside thepredetermined volumetric rate value (e.g., 100 ml/hour) for thethreshold number of times, then the processor 202 may calculate anaverage (e.g., 105 ml/hour) of the administered volumetric rates anddetermine the new value of the volumetric rate of the medication as theaverage (e.g., 105 ml/hour) of the administered volumetric rates, and/ormay cause the new value of the volumetric rate to displayed via aneditor of a medication system. In some implementations, the processor202 may determine the new value for only a predetermined care area inwhich the medication is administered outside of the predetermined valuefor the administration parameter. For example, if a medication isadministered at a volumetric rate that is outside the predeterminedvolumetric rate value for the threshold number of times in ICU, then theprocessor 202 may calculate an average of the volumetric rates at whichthe medication is administered in that ICU, and may determine the newvalue of the volumetric rate of the medication in that ICU as theaverage of the administered volumetric rates in that ICU.

The processor 202 may transmit the determined new value to a user of adrug management system in a message indicating the new value as asuggested update to the predetermined value. In some implementations,the processor 202 may indicate in the message that the new value is fora predetermined care area. In some implementations, the processor 202may display the determined new value in an editor user interface for thevarious medications stored in a data storage system associated with thedrug management system.

Turning now to FIG. 9 , there is shown a flowchart illustrating aprocess of rating and identifying one or more high performing externalclinician staffing resource centers. For the purpose of illustrating aclear example, components of the network architecture 100, shown anddescribed with reference to FIG. 1A, components shown and described withreference to FIG. 1B, components of the device management server 108,shown and described with reference to FIG. 2 , and components of themedical devices 104, shown and described with reference to FIGS. 3, 4,and 5 may be used to describe the process of identifying one or morehigh performing external clinician staffing resource centers.

The method 900 includes identifying, by the processor 202 of the devicemanagement server 108, one or more clinicians that are associated withexternal clinician staffing resource centers (block 901). The devicemanagement server 108 may receive clinician information from a clinicianstaffing system of the healthcare facility, and the clinicianinformation may specify external clinician staffing resource centers forthe clinicians that are temporarily staffed and/or are travelingclinicians. The processor 202 may store the clinician (e.g., anidentifier of the clinician) in association with the correspondingexternal clinician staffing resource center in a data storage systemassociated with the device management server 108. The processor 202 mayidentify the one or more clinicians based on their associations with theexternal clinician staffing resource centers.

The processor 202 determines a set of clinicians from the one or moreclinicians that satisfy a threshold performance score (block 902). Asdescribed above, the processor 202 stores the performance score of theclinician in association with the clinician (e.g., identifier of theclinician) in a data storage system. The processor 202 may identify theperformance score for each of the one or more clinicians and determinewhether the performance score satisfies a threshold performance score(e.g., the performance score is equal to or greater than the thresholdperformance score). The threshold performance score may be apredetermined performance score specified by healthcare facility. If theperformance score of a clinician satisfies a threshold performancescore, then the processor 202 may add the clinician to a set ofclinicians.

The processor 202 identifies one or more external clinician staffingresource centers as high performing clinician resource centers based onthe set of the clinicians (block 903). The processor 202 may identifyone or more external clinician staffing resource centers with athreshold number of clinicians in the determined set, and identify themas the one or more external clinician staffing resource centers. Forexample, the threshold number may be predetermined to be 3, and theprocessor 202 may group the clinicians in the set based on theirassociated external clinician staffing resource centers, and identifythe external clinician staffing resource centers with at least 3clinicians. In some implementations, the processor 202 may be configuredto identify one or more clinicians with the highest performance score,and identify their associated external clinician staffing resourcecenters as high performing external clinician staffing resource centers.In some implementations, the processor 202 may be configured to generatea rating for each of the one or more external clinician staffingresource centers based on the number of clinicians with performancescores satisfying the threshold performance score and associated withthe resource center.

The processor 202 may transmit a message to a staffing system of thehealth care facility indicating the one or more high performing externalclinician staffing resource centers to a staffing system of the healthcare facility (block 904). In some implementations, the processor 202may cause the staffing system to request clinician(s) from the one ormore the high performing external clinician staffing resource centers inresponse to transmitting the message to the staffing system.

Turning now to FIG. 10 , there is shown a flowchart illustrating aprocess of verifying and/or optimizing a shift schedule for clinicians.For the purpose of illustrating a clear example, components of thenetwork architecture 100, shown and described with reference to FIG. 1A,components shown and described with reference to FIG. 1B, components ofthe device management server 108, shown and described with reference toFIG. 2 , and components of the medical devices 104, shown and describedwith reference to FIGS. 3, 4, and 5 may be used to describe the processof an optimized scheduling of clinicians.

The method 1000 includes receiving, by the processor 202 of the devicemanagement server 108, a shift schedule for clinicians at a health carefacility (block 1001). In some implementations, the performance scoresof the clinicians in the shift schedule may be received. The processor202 determines whether the received shift schedule satisfies one or morescheduling criteria associated with a health care facility (block 1002).The device management server 108 may be configured to receive one ormore scheduling criteria for a health care facility, and the processor202 may store the received scheduling criteria in association with thehealth care facility. The processor 202 may be configured to verifyand/or optimize the received shift schedule based on the schedulingcriteria associated with the health care facility. In someimplementations, a scheduling criteria may indicate a ratio ofclinicians with non-low performance scores to clinicians with lowperformance scores. For example, a scheduling criteria may indicate that3 clinicians with non-low performance scores should be scheduled forevery 2 clinicians with low performance scores that are scheduled.

In some implementations, the processor 202 may be configured to apply ascheduling criteria based on the time of the shift. For example, theprocessor 202 may be configured to apply a scheduling criteriaindicating 2 clinicians with non-low performance scores for every 2clinicians with low performance scores for a night shift and ascheduling criteria indicating 4 clinicians with non-low performancescores for every 2 clinicians with low performance score for anafternoon shift. The processor 202 may identify the performance scoresfor the clinicians included in the received shift schedule and, based onthe performance scores of the clinicians, determine if the ratio ofclinicians with non-low performance scores to clinicians with lowperformance scores included in the shift schedule satisfies theindicated ratio of the scheduling criteria. If the ratio is satisfied,then the processor 202 may determine that the received shift schedulesatisfies that scheduling criteria.

In some implementations, a scheduling criteria indicates a thresholdaverage performance score for a shift based on the performance scores ofthe clinicians scheduled for the shift. The processor 202 may calculatean average performance score based on the performance scores associatedwith the clinicians included in the received shift schedule, and maydetermine that such a scheduling criteria is satisfied if the calculatedaverage performance satisfies the indicated threshold averageperformance score, then the processor 202 may determine that thereceived shift schedule satisfies such a scheduling criteria. In someimplementations, a scheduling criteria may indicate a thresholddeviation between the performance scores of the clinicians included in ashift schedule to achieve even distribution of performance scores acrossdifferent shifts at the health care facility. The processor 202 may beconfigured to determine whether the shift schedule satisfies thisscheduling criteria based on whether differences between the performancescores of the clinicians included in the shift schedule satisfy thethreshold deviation.

If the processor 202 determines that the received shift schedule doesnot satisfy one or more scheduling criteria associated with thehealthcare facility (‘NO’ at block 1002), then the method 1000 proceedsto block 1003. The processor 202 adjusts the received shift schedule(block 1003). The processor 202 may be configured to adjust the receivedshift schedule by swapping one or more clinicians included in the shiftschedule with one or more other clinicians currently not scheduled forthat shift and/or a shift during the same time period as the time periodof the shift associated with the received shift schedule. For example,the processor 202 may adjust the received shift schedule and/or generatea new shift schedule by replacing a first clinician with a performancescore not satisfying a threshold performance score specified in ascheduling criteria in the received shift schedule with a secondclinician not scheduled during the same time period as the time periodof the shift of the received shift schedule, based on the performancescore of the second clinician satisfying the specified thresholdperformance score. In some implementations, the processor 202 mayelectronically prevent the first clinician from using one or moremedical devices during the time period of the shift of the receivedshift schedule.

In some implementations, the processor 202 may be configured to swap forone or more clinicians scheduled for a different shift. In someimplementations, the processor 202 may swap for one or more cliniciansscheduled for a shift that has not yet started. The processor 202 may beconfigured to continue to swap one or more clinicians between differentshifts until schedules of each shift satisfy the one or more schedulingcriteria associated with the health care facility. The processor 202 maybe configured to store the one or more adjusted schedules in a datastorage system associated with the device management server 108. Theprocessor 202 transmits a message to a clinician schedule systemindicating one or more adjusted schedules (block 1004). The processor202 may include an instruction in the message to cause the clinicianschedule system to update the corresponding schedules of the adjustedschedules in the clinician schedule system.

Returning now to block 1002, if the processor 202 determines that thereceived shift schedule satisfies the one or more scheduling criteriaassociated with the healthcare facility (‘YES’ at block 1002), then themethod 1000 proceeds to block 1005. The processor 202 transmits amessage to the clinician schedule system indicating that the shiftschedule successfully satisfies the one or more scheduling criteriaassociated with the healthcare facility (block 1005).

In some implementations, the processor 202 may be configured to causethe schedule of the clinicians to be displayed on display devices of themedical devices 104. For example, the processor 202 may identify, basedon the verified and/or the optimized schedule, patients associated witheach clinician and the medical devices 104 associated with patients. Theprocessor 202 may transmit information related to the clinician'sschedule (e.g., information related to when the clinician's shift startsand ends) to the medical device 104 for the clinician's shift scheduleto be displayed on the display device of the medical device 104. In someimplementations, the processor 202 may be configured to transmit theverified and/or optimized schedule to be displayed on a display deviceassociated with the clinician scheduling system.

Turning now to FIG. 11 , there is shown a flowchart illustrating aprocess of identifying workflows and generating alerts and/or remindersfor follow-up activity for clinicians with low performance scores. Forthe purpose of illustrating a clear example, components of the networkarchitecture 100, shown and described with reference to FIG. 1A,components shown and described with reference to FIG. 1B, components ofthe device management server 108, shown and described with reference toFIG. 2 , and components of the medical devices 104, shown and describedwith reference to FIGS. 3, 4, and 5 may be used to describe the processof generating alerts and/or reminders for follow-up activity forclinicians with low performance scores.

The method 1100 includes receiving, by the processor 202 of the devicemanagement server 108, an identifier of a clinician from a medicaldevice (block 1101). As described above, in some implementations, theprocessor 202 may receive the identifier of the clinician after theclinician is granted access to the medical device. The processor 202identifies a performance score associated with the clinician (block1102). As described above, a performance score of the clinician may bestored in association with the clinician (e.g., identifier of theclinician) in a data storage system associated with the devicemanagement server 108, and the processor 202 identifies the performancescore based on information related to the clinician and/or the receivedidentifier of the clinician.

The processor 202 receives information related to one or moreinteractions of the clinician with the medical device (block 1103). Theprocessor 202 determines whether the performance score of the cliniciansatisfies a threshold low performance score (block 1104). If theprocessor 202 determines that the performance score of the cliniciandoes not satisfy the threshold low performance score (‘NO’ at block1104), then the method 1100 terminates. If the processor 202 determinesthat the performance score of the clinician satisfies threshold thethreshold low performance score (‘YES’ at block 1104), then the method1100 proceeds to block 1105.

The processor 202 identifies one or more next steps for the clinician(block 1105). The processor 202 may be configured to identify one ormore next steps for the clinicians based on a stored set of rules thatspecify one or more next steps in the different workflows with which themedical device is configured. In some implementations, the processor 202may be configured to identify an appropriate next step in a workflowbased on a last completed step and/or a current step in the workflow. Insome implementations, the processor 202 may identify the last completedstep and/or a current step in the workflow, based on the receivedinformation related to the one or more interactions with the medicaldevice by the clinician. For example, if the received informationrelated to the one or more interactions indicate that the last stepcompleted by the clinician is selection of infusion of a medication,then the processor 202 may identify that the next step is checking asetting in the medical device based on the one or more next stepsspecified by the stored set of rules for the infusion workflow for thatmedical device.

The processor 202 causes the one or more identified next steps to bedisplayed on a display device associated with the medical device (block1106). In some implementations, the processor 202 may transmit the oneor more identified next steps and an instruction to display the one ormore transmitted next steps to the medical device to cause the medicaldevice to display the one or more next steps on a display deviceassociated with the medical device. In some implementations, the medicaldevice may be configured to display graphical items (e.g., alert boxes,message boxes, and the like) associated with the steps in a workflowwith which the medical device is configured, and the processor 202 maytransmit a message and/or an instruction indicating identifiersassociated with the identified next step(s) to cause a processor of themedical device (e.g., processor 302) to identify the next step(s) in thestored steps for the workflow and display them on a display deviceassociated with the medical device using the associated graphical items.

The processor 202 determines one or more follow-up activities for theclinician (block 1107). Examples of follow-up activities include, butare not limited to, checking one or more settings and/or configurationdata for a medical device, checking operational errors of the medicaldevice, checking vital signs of the patient, and the like. The processor202 may determine the one or more follow-up activities based on the oneor more identified next steps. For example, if an identified next stepis to provide an input to start an infusion of a medication, then theprocessor 202 may determine a follow-up activity of confirming anoperational status of a pump module connected to the medical deviceafter a predetermined amount of time. In some implementations, theprocessor 202 may determine the one or more follow-up activities basedon the information related to the one or more interactions of theclinician with the medical device. For example, if the informationrelated to the one or more interactions of the clinician with themedical device indicate that a patient associated with the medicaldevice is disconnected from the medical device, then the processor 202may determine a follow-up activity of confirming that a record of thepatient in an EMR system accurately indicates the time at which theclinician is disconnected from the medical device.

The processor 202 generates and transmits one or more alerts and/orreminders indicating the one or more determined follow-up activities tothe clinician and/or other computing systems of the health care facilitythat are communicatively coupled to the device management server 108(block 1108). In some implementations, the processor 202 may beconfigured to transmit an alert and/or reminder for a determinedfollow-up activity based on whether the determined follow-up activityincludes performing one or more tasks in a computing system of thehealth care facility. If the processor 202 determines that the follow-upactivity includes performing one or more tasks in a computing system,then the processor 202 may transmit the alert and/or reminder to thecomputing system to cause the alert and/or reminder to be displayed on adisplay device of the computing system. For example, if the follow-upactivity includes updating a patient record in an EMR system of thehealthcare facility, then the processor 202 may transmit an alert and/orreminder for the follow-up activity to the EMR and cause the alertand/or reminder to be displayed in response to the clinician accessingthe EMR. In some implementations, the processor 202 may transmit the oneor more alerts and/or reminders to a computing device associated with aclinician (e.g., mobile device of the clinician) to provide the one ormore alerts and/or reminders to the clinician. In some implementations,the processor 202 may be configured to lock the clinician out of themedical devices 104 if the clinician does complete one or more tasks ofthe follow-up activity within a predetermined threshold of time (e.g.,within 3 hours) associated with the follow-up activity.

Turning now to FIG. 12 , there is a shown flowchart illustrating aprocess of determining a compliance score and generating a training planfor a clinician. For the purpose of illustrating a clear example,components of the network architecture 100, shown and described withreference to FIG. 1 , components of the device management server 108,shown and described with reference to FIG. 2 , and components of themedical devices 104, shown and described with reference to FIG. 3 , maybe used to describe the process determining a compliance score andgenerating a training plan for a clinician.

The method 400 includes receiving, by the processor 202 of the devicemanagement server 108 information related to an identifier of aclinician at a medical device 104 (block 401). The processor 202 mayreceive information related to an identifier of a clinician in responseto the clinician attempting to access a medical device 104. In someimplementations, the clinician may attempt to access a medical device104 by providing his or her access credentials to the medical device 104(e.g., scanning his or her identification card at the medical device104). A clinician's access credentials may be associated with and/orinclude a unique identifier of the clinician, and the medical device 104may be configured to transmit the unique identifier associated with theclinician to the device management server 108 in response to receivingthe clinician's access credentials and/or a unique identifier. Examplesof a unique identifier of a clinician include, but are not limited to, auser identifier, an employee identifier, and the like. In someimplementations, the processor 202 may determine whether to grant accessto the clinician for the medical device 104 based on whether theclinician requires a secondary authorization for the clinician.

The processor 202 receives information related to one or moreinteractions of the clinician with the medical device (block 402).Examples of the information related to interactions of the clinicianwith a medical device 104 include, but are not limited to,administration of a certain medication to a patient, volumetric rate ofa medication administered (e.g., administering a medication at a rate of5 milliliter per hour), administration of two or more medicationsconcurrently, medication-to-medication interactions of concurrentlyadministered medications, volume of a medication administered, dosage ofa medication administered, care area in which the clinician interactedwith the medical device, class of medication administered, type ofpatients to whom medication administered, response time to one or morealarms generated by a medical device, medical route (e.g.,intravenously, subcutaneous, arterial, epidural, and the like) ofadministering a medication, type of set (e.g., tubing, syringe, orconnections) for an administration of fluid or medication, duration ofuse of a set for an administration, type of tubing and connections usedduring infusion, tubing change parameters (e.g., tubing changed in 72hours, 96 hours, and the like), and other similar information. Theinteractions may also be associated with a sequence to determine whichinteractions occurred and an order or timing for the interactions thatoccurred.

The processor 202 generates a compliance score for the clinician basedon the one or more interactions (block 403). The processor 202 may beconfigured to generate a compliance score based on whether aninteraction is compliant with one or more protocols. In someimplementations, the processor 202 may determine whether an interactionis compliant based on a stored set of rules that indicate or specify oneor more corresponding compliant interactions. For example, the set ofrules may specify compliant volumetric rates for one or moremedications. Similarly, the set of rules may specify one or more ofpressure rates, dosage, volume, set type, and the like. In someimplementations, the set of rules may specify one or more compliantparameters for one or more medications, types of patients, care areaswithin a health care facility, class of medications, and the like. Theset of rules may also specify one or more groups of medications that maybe simultaneously or sequentially administered. In some implementations,the set of rules may specify different compliant volumetric rates,pressure rates, dosage rates, and the like for different types ofpatients (e.g., patients with a heart condition, obese patients,patients with one or more allergies, and the like). The set of rules mayfurther specify the different medical routes of administration via whicha medication may be administered. Examples of medical routes ofadministration include, but are not limited to, intravenous, epidural,subcutaneous, other parenteral routes, and the like.

The processor 202 may compare the information related to the one or morereceived interactions and corresponding compliant interactions specifiedby the set of rules to determine whether the interactions are compliant.For example, if the clinician administered two medicationssimultaneously and the set of rules specify one or more sets and/orgroups of medications that may be simultaneously administered, then theprocessor 202, may verify whether both medications are specified as partof a group or a set of medications that can be administeredsimultaneously. If the processor 202 determines that both medicationsare not part of a group or set of medications that can be administeredsimultaneously, then the processor 202 may determine that theclinician's interactions are non-compliant and generates and/or adjusts(e.g., reduces) a compliance score of the clinician to reflect theclinician's non-compliant interactions. If the processor 202 determinesthat both medications are part of a group or set of medications that canbe administered simultaneously, then the processor 202 may determinethat the clinician's interactions are compliant and generates and/oradjusts (e.g., increases) a compliance score of the clinician to reflectthe clinician's compliant interactions.

A compliance score may be determined by identifying the rules applicableto the interactions for a selected period of time. In an interactiveimplementation, the period of time may be selected via user interface.In an unattended implementation, such as a periodic compliance reportingengine, the period of time may be specified as a configuration parameterof the reporting engine. The processor 202 may obtain the interactionsfor the subject(s) over the period of time. The processor 202 may thenobtain the applicable compliance rules from the set of compliance rules.This filtering can reduce the amount of resources needed to generate thecompliance scores for the subject(s). Once the applicable compliancerules are obtained, the processor 202 may then assess the interactionsby comparing an interaction with an applicable rule. An interactionrecord may include an interaction type. The interaction type may be usedas a key for identifying relevant compliance rules by, for example,matching an identifier for the interaction type to a value specified inor by a compliance rule. The interaction record may also includeinteraction data identifying, for example, the volume programmed, therate programmed, or other clinician behavior for the interaction. Eachrule may contribute a value to a composite compliance score. The rulesmay be normalized to a risk scale whereby a first limit is associatedwith safe or compliant behavior and a second limit is associated withunsafe or non-compliant behavior. This normalization allows each rule tocontribute equally to a composite score.

Equation (1) provides one example expression for generating a compositecompliance score. Some implementations may include a weighting factor toallow certain rules or interactions to contribute more or less heavilyto a compliance score. A weighting factor may be specified for allscores or may be adjusted for specific clinician or groups of cliniciansto emphasize or deemphasize performance of certain activities.

$\begin{matrix}{{\sum\limits_{i = 0}^{n}{\sum\limits_{r = 0}^{x}{\omega_{ri}s_{r}}}}(i)} & {{Equation}\mspace{14mu} 1}\end{matrix}$where

-   -   n is the number of interactions;    -   x is the number of rules applicable to a given interaction (i);    -   ω is a weighting factor for a given rule (r) or interaction (i);        and    -   sr is a scoring function for the given rule (r) as applied to        the data from the interaction (i).

In some implementations, the processor 202 may be configured to comparethe information related to the one or more interactions of one clinicianwith interactions of other clinicians and determine whether the one ormore interactions of one clinician is compliant. For example, for afirst clinician, if the processor 202 receives information related to aninteraction indicating that the first clinician administered amedication at a pressure rate, then the processor 202 may comparewhether the pressure rate at which the first clinician administered themedication is outside of a range of pressure rates used by a majority ofother clinicians. If the processor 202 determines that the pressure rateis outside of a range of pressure rates, then the processor 202 maydetermine that the interaction of the first clinician is non-compliant.Similarly, if the processor 202 determines that the pressures is notoutside of a range of pressure rates, then the processor 202 maydetermine that the interaction of the first clinician is compliant.

The processor 202 may be configured to adjust a compliance score by apredetermined adjustment amount. In some implementations, the processor202 may be configured to determine an adjust amount based on howfrequently the clinician's interactions were non-compliant over apredetermined period of time. For example, if the clinician administersa medication at an incorrect dosage several times over a period of 30days, then the processor 202 may decrease a compliance score by agreater amount every time the clinician administered the medication atincorrect dosages. In some implementations, each clinician may beassociated with a default starting compliance score, and the processor202 may store the compliance score in association with an identifier ofthe clinician. The processor 202 may update and/or maintain thecompliance score over a career of the clinician.

In some implementations, the processor 202 may group and/or categorizethe clinician interactions into predetermined groups and/or categoriesbased on a predetermined set of rules. For example, the processor 202may group and/or categorize interactions related to administering amedication at a dosage as one group and/or category of interactions, maygroup and/or categorize interactions related to administering amedication at a volumetric rate as a second group and/or category ofinteractions, may group and/or categorize interactions related toadministering multiple medications simultaneously as a third groupand/or category of interactions. The processor 202 may generate and/orassociate a compliance score for each group and/or category ofinteractions. In some implementations, the processor 220 may generate anoverall compliance score based on the compliance scores of one or moregroups and/or categories of interactions.

The processor 202 determines whether the compliance score satisfies atraining plan threshold compliance score (block 404). A training planthreshold compliance score may be a predetermined threshold compliancescore. The threshold compliance score may be specified as a system-wideconfigurable value. In some implementations, the configurable value maybe specified via a user interface. In some implementations, thethreshold compliance score may be dynamically generated such as forspecific clinicians or group of clinicians. In some implementations, theprocessor 202 may be configured to determine that the compliance scoresatisfies the training plan threshold compliance score if the compliancescore is corresponds to the training plan threshold compliance score. Insome implementations, if the compliance score is equal to or greaterthan a training plan threshold compliance score, then the processor 202may be configured to determine that the compliance score satisfies thetraining plan threshold compliance score.

If the processor 202 determines that the compliance score does notsatisfy the threshold compliance score (e.g., the clinician orclinicians are deemed compliant), then the method 400 proceeds to block401. If the processor 202 determines that the compliance score satisfiesthe threshold compliance score (e.g., the clinician or clinicians aredeemed out of compliance), then the method 400 proceeds to block 405.The processor 202 generates a training plan (block 405). The processor202 may identify training modules associated with the one or moreinteractions and/or category of the one or more interactions. Forexample, if the one or more non-compliant interactions are associatedwith a category of administering a medication at a volumetric rate, thenthe processor 202 may identify training modules associated with thatcategory. In some implementations, one or more training modules may beassociated with one or more training videos, and the processor 202 maycompile the one or more training videos into a software package andassociate the package with the training plan. In some implementations,the processor 202 may request and/or receive key stroke and/or touchinput data from medical devices configured to receive key stroke and/ortouch input, and the processor 202 may associate the received key strokeand/or touch input data with the training videos and/or training plan.In some implementations, the processor 202 may generate one or morevideos based one the key stroke and/or touch input data and provide themto the clinician for a visual feedback of the clinician's interactionswith the medical device.

The processor 202 may specify one or more training tasks in the trainingplan. The one or more training tasks may specify instructions and/ortasks for the clinician to perform to complete the training plan. Thetraining tasks may specify training materials for the clinician toreview and/or tests to verify that the clinician reviewed the trainingmaterials, training videos to review, and the like. In someimplementations, the processor 202 may determine whether the cliniciancompleted a training plan based on whether the clinician completed thetraining tasks. The processor 202 may transmit the training plan to theclinician. In some implementations, the processor 202 may store thetraining plan in association with the clinician's identifier andtransmit a message comprising a link to the training plan to theclinician.

In some implementations, the processor 202 may associate the clinicianwith a secondary authorization from other clinicians that have a highercompliance score than the clinician. For example, the processor 202 mayidentify clinicians with compliance scores equal to or above a certainthreshold compliance score, and associate one or more of the identifiedclinicians as secondary authorization for the clinician. By associatingone or more other clinicians as secondary authorization for theclinician, the processor 202 causes the medical device to display aprompt for the one or more other clinicians to login or access themedical device while the clinician is accessing the medical device.

The processor 202 may adjust one or more features available for theclinician at one or more medical devices based on the training plan(block 406). In response to determining that the clinician is grantedaccess to the medical device, the processor 202 may cause the medicaldevice to display additional prompts or messages to the clinician basedon the generated training plan. For example, the processor 202 maytransmit a training video associated with the training plan to themedical device and cause the medical device to display the trainingvideo in response to the clinician being granted access to the medicaldevice. The processor 202 may cause the medical device to displaydifferent training videos associated with the training plan at differentsteps of an interaction. For example, if the clinician is administeringa medication intravenously, then the processor 202 may instruct themedical device to display a first video of the training that instructsthe user to verify if the medication can be administered intravenouslyand provide a prompt to the clinician to confirm that the medication canbe administered intravenously. In response to receiving a confirmationfrom the clinician, the processor 202 may cause the medical device todisplay a second video that instructs the clinician to verify if thedosage of the medication is suitable for that particular patient.

In some implementations, the processor 202 disable certain features forthe clinician at one or more medical devices based on the training plan.For example, the processor 202 may disable features that can allow aseasoned clinician to skip a few intermediate steps, and cause theclinician associated with the training plan to perform additional steps(e.g., checking labels and confirming labels are checked), which aclinician with a higher compliance score may not have to perform. Insome implementations, the processor 202 may lock the clinician out ofone or more medical devices until the processor 202 determines that theclinician has successfully completed the training plan. A medical devicemay include an idle time lock out value. Once a clinician accesses themedical device, if no interactions are detected with the medical devicefor a period of time, the clinician may be deemed idle. This absence ofactivity may be recorded as an interaction with the medical device andprocessed as described. The period time used to assess idleness may bedynamically adjusted. For example, a clinician having a low compliancescore may have a higher idle time than a clinician with a highercompliance score. This may encourage the low performing clinician totake their time while interacting with the medical device. The lowerthreshold for the more competent clinician may improve security of themedical device. The period of time may be further generated based on thedrug to be delivered, type of infusion, administration set, or otherdetectable property of the medication delivery.

The processor 202 may monitor and/or track the training plan todetermine whether the clinician has completed one or more tasks of thetraining plan. In some implementations, in response to determining thatone or more tasks of the training plan are completed, the processor 202may enable one or more features associated with the training tasks. Insome implementations, the processor 202 may grant access to one or moremedical devices to the clinician if a threshold number of training tasksare completed.

The processor 202 may control additional or alternative aspects of themedical device based on competence score. For example, the medicaldevice may dynamically require secondary review for an activity based onthe competence score of the clinician initiating the activity. Forexample, if a controlled substance is to be delivered via a medicaldevice and the clinician's competence score is below a threshold, themedical device may prevent initiation of the delivery until confirmed bya second clinician. In some implementations, the medical device may beconfigured to receive confirmation from a second clinician having acompetence score greater than the first clinician or greater than athreshold. The threshold may be associated with the medical device,drug, care area for the clinician, or a standard competency threshold.Additional or alternative factors that may be used to configure themedical device for secondary review include the infusion type, thenumber of channels running for a programming module, differences betweenan order and actual programmed parameters (e.g., more deviations fromprovided programming parameters can indicate a higher probability ofclinician error), administration set type (e.g., some sets requirespecific priming or may be prone to loading errors), patientcharacteristic (e.g., a patient has specific medical condition, needs,etc.).

In some implementations, the medical device may be configured to requirea specific clinician to review and approve an interaction. For example,a nursing manager's confirmation may be required to initiate a programentered by a junior nurse. As another example, a specific physician'sconfirmation may be required to initiate a program for an experimentaldrug or therapy (e.g., as part of a clinical trial). The identity may beconfirmed by activating a credentialing system to receive identifyinginformation for the secondary reviewer. For example, the medical devicemay scan a badge associated with the secondary reviewer. The scan mayprovide an identifier for the secondary reviewer which can then be usedto confirm identity, competence score, or other factor to assess whetherthe individual can review the work of the initiating clinician. Anattempt and result (e.g., authorized, rejected) of a particularsecondary reviewer may be stored as an interaction and included in theprocessing described herein.

The compliance score described thus far is generally associated with aclinician. In some implementations, the compliance score may begenerated for devices. In some cases, it may be that the device, not theclinician, needs attention. In such implementations, interactions with aspecific device, model or series of device, or device type may beidentified and scored. Based on the compliance score, one or morecontrol signals may be transmitted to a device identified to be out ofcompliance. The control signal may adjust one or more features of thedevice such as disabling the login or adjusting the power status (e.g.,sleep mode or turn off). In some implementations, the control signal mayadjust a user interface or other perceivable feedback element toindicate the device may not be properly functioning. In someimplementations, the control signal may be transmitted to a technicianor other automated troubleshooting system to initiate maintenance on thedevice. The maintenance may include executing a remote diagnosticprocess or system refresh to identify or correct deficiencies with thedevice.

Although some of various drawings illustrate a number of logical stagesin a particular order, stages that are not order dependent may bereordered and other stages may be combined or broken out. While somereordering or other groupings are specifically mentioned, others will beobvious to those of ordinary skill in the art, so the ordering andgroupings presented herein are not an exhaustive list of alternatives.Moreover, it should be recognized that the stages could be implementedin hardware, firmware, software, or any combination thereof.

With further reference to FIG. 1-12 , the system of the subjecttechnology may identify one or more interactions of a first user withone or more medical devices, and determine, based on the one or moreinteractions and a predetermined set of rules, a compliance scoreassociated with the first user. In response to the compliance score notsatisfying a threshold compliance score, the system may reduce an accesslevel of the first user to at least one of the one or more medicaldevices and generating a training program associated with the at leastone medical device and the one or more interactions. In this regard,reducing the access level may include reducing a number of respectivefeatures of the at least one medical device that are available to thefirst user. The system is configured to then, without user involvement,automatically compile and/or send a training package associated with thetraining program to the first user and notify the first user to completethe training program using the training package.

The system may then (at a later time) receive a request for the firstuser to access the at least one medical device. For example, the firstuser may attempt to log in to the medical device (e.g., swipe his or herbadge). The system may then determine, responsive to the request, thatthe first user has not completed the training program, and requireauthorization from a second user authorized to use the at least onemedical device before granting the request for the first user to accessthe at least one medical device. According to various implementations,the training program may be generated based on a category associatedwith the one or more interactions and includes one or more trainingtasks associated with the number of respective features of the at leastone medical device. In some implementations, the system may determinethat the first user completed the training program, including the one ormore training tasks, and restore, responsive to determining that thefirst user completed the training program, the access level of the firstuser with regard to the at least one medical device. In someimplementations, each of the one or more respective features of themedical device are made available to the first user as a correspondingtraining task associated with each feature is completed by the firstuser.

Illustration of Subject Technology as Clauses

Various examples of aspects of the disclosure are described as numberedclauses (1, 2, 3, etc.) for convenience. These are provided as examples,and do not limit the subject technology. Identifications of the figuresand reference numbers are provided below merely as examples and forillustrative purposes, and the clauses are not limited by thoseidentifications.

Clause 1. A method comprising: tracking one or more interactions of afirst user with one or more medical devices; determining, based on a setof stored rules and the one or more interactions, a compliance score;determining whether the compliance score satisfies a thresholdcompliance score; in response to determining that the compliance scoresatisfies the threshold compliance score, generating, based on the oneor more interactions, a training plan for the first user; and adjusting,based on the training plan, one or more features of the one or moremedical devices available for the first user at the one or more medicaldevices.

Clause 2. The method of Clause 1, further comprising: receiving arequest for access to a medical device of the one or more medicaldevices, wherein the request is associated with an identifier of thefirst user; determining whether an identifier of a second user from aplurality of users is granted access to the medical device; and inresponse to determining that the identifier of the second user isgranted access to the medical device, granting the identifier of thefirst user access to the medical device.

Clause 3. The method of Clause 2, wherein the identifier of the seconduser is associated as secondary authorization for the identifier of thefirst user.

Clause 4. The method of Clause 3, wherein determining whether theidentifier of the second user is granted access to the medical device,further comprises: in response to receiving the request for access fromthe first user, providing for display on a display device associatedwith the medical device a request for credentials associated with theidentifier of the second user; receiving credentials associated with theidentifier of the second user; and granting the identifier of the seconduser access to the medical device.

Clause 5. The method Clause 3, wherein a compliance score of the seconduser is greater than the compliance score of the first user.

Clause 6. The method of Clause 1, wherein generating, based on the oneor more interactions, the training plan for the first user furthercomprises: determining, based on the one or more interactions, acategory associated with the one or more interactions; identifying,based on the category, one or more training modules; and generating,based on the one or more training modules, the training plan.

Clause 7. The method of Clause 6, wherein the training plan comprisesone or more training tasks corresponding to the one or more trainingmodules and the features of the one or more medical devices.

Clause 8. The method of Clause 7, further comprising: determiningwhether a training task of the one or more training tasks of thetraining plan is completed; and in response to determining that thetraining task is completed, granting access to a corresponding featureof the medical device to the first user.

Clause 9. The method of Clause 1, wherein adjusting, based on thetraining plan, the one or more features of the one or more medicaldevices available for the first user at the one or more medical devicesfurther comprises: providing a training video associated with the one ormore features for display on a display device associated with one of theone or more medical devices.

Clause 10. The method of Clause 1, further comprising: locking out thefirst user from the one or more medical devices; receiving a request toaccess the one or more medical devices by the first user; in response toreceiving the request, determining whether the first user completed thetraining plan; and in response to determining that the first usercompleted the training plan, granting access to the first user for theone or more medical devices.

Clause 11. A system comprising: a memory storing instructions; and oneor more processors coupled with the memory and configured to execute theinstructions to cause the system to: track one or more interactions of afirst user with one or more medical devices; determine, based on a setof stored rules and the one or more interactions, a compliance score;determine whether the compliance score satisfies a threshold compliancescore; when the compliance score satisfies the threshold compliancescore, generate, based on the one or more interactions, a training planfor the first user; and adjust, based on the training plan, one or morefeatures of the one or more medical devices available for the first userat the one or more medical devices.

Clause 12. The system of Clause 11, wherein the one or more processorsare configured to execute instructions to cause the system to: receive arequest for access to a medical device of the one or more medicaldevices, wherein the request is associated with an identifier of thefirst user; determine whether an identifier of a second user from aplurality of users is granted access to the medical device; and when theidentifier of the second user is granted access to the medical device,granting the identifier of the first user access to the medical device.

Clause 13. The system of Clause 12, wherein the identifier of the seconduser is associated as secondary authorization for the identifier of thefirst user.

Clause 14. The system of Clause 13, wherein the one or more processorsare configured to execute instructions to cause the system to: when therequest for access from the first user is received, provide for displayon a display device associated with the medical device a request forcredentials associated with the identifier of the second user; receivecredentials associated with the identifier of the second user; and grantthe identifier of the second user access to the medical device.

Clause 15. The system of Clause 13, wherein a compliance score of thesecond user is greater than the compliance score of the first user.

Clause 16. The system of Clause 11, wherein the one or more processorsare configured to execute instructions to cause the system to:determine, based on the one or more interactions, a category associatedwith the one or more interactions; identify, based on the category, oneor more training modules; and generate, based on the one or moretraining modules, the training plan.

Clause 17. The system of Clause 16, wherein the training plan comprisesone or more training tasks corresponding to the one or more trainingmodules and the features of the one or more medical devices.

Clause 18. The system of Clause 17, wherein the one or more processorsare configured to execute instructions to cause the system to: determinewhether a training task of the one or more training tasks of thetraining plan is completed; and when the training task is completed,granting access to a corresponding feature of the medical device to thefirst user.

Clause 19. The system of Clause 11, wherein the one or more processorsare configured to execute instructions to cause the system to: provide atraining video associated with the one or more features for display on adisplay device associated with one of the one or more medical devices.

Clause 20. The system of Clause 11, wherein the one or more processorsare configured to execute instructions to cause the system to: lock outthe first user from the one or more medical devices; receive a requestto access the one or more medical devices by the first user; when therequest is received, determine whether the first user completed thetraining plan; and when the first user has completed the training plan,grant access to the first user for the one or more medical devices.

Clause 21. A method comprising: identifying interactions of a pluralityof clinicians with one or more medical devices; generating, based on aset of stored rules and one or more interactions of each user of theplurality of clinicians, a performance score for each of plurality ofclinicians; receiving a first shift schedule associated with theplurality of clinicians; determining whether the first shift schedulesatisfies one or more scheduling criteria associated with a healthcarefacility; in response to determining that the first shift schedule doesnot satisfy the one or more scheduling criteria and a first performancescore for a first clinician not satisfying a first evaluation thresholdof the one or more scheduling criteria: (1) generating a new secondshift schedule for the plurality of clinicians that replaces a firstclinician scheduled during a first time period with a second cliniciannot currently scheduled during the time period based on a secondperformance score of the second clinician, and (2) electronicallypreventing the first clinician from using at least one of the one ormore medical devices during the first time period; and causing the newschedule for the shift to be displayed on a display device associatedwith a clinician scheduling system.

Clause 22. The method of Clause 21, further comprising: identifying,based on performance scores of a subset of the plurality of clinicians,one or more high performing resource centers; generating a request forone or more clinicians not among the plurality of clinicians from theone or more high performing resource centers; and transmitting therequest to the clinician scheduling system.

Clause 23. The method of Clause 21, further comprising: determining asubset of the plurality of clinicians whose performance scores satisfy athreshold low performance score; receiving information related tointeractions of a clinician of the subset with a medical device;identifying, based on the information, a workflow initiated at themedical device; identifying, based on the workflow and the set of storedrules, a next step in the workflow; and causing the next step to bedisplayed on a display device associated with medical device.

Clause 24. The method of Clause 23, further comprising: determining,based on the information related to the one or more interactions, one ormore follow-up activities for the clinician; generating an alert for theone or more follow-up activities; and transmitting the alert for the oneor more follow-up activities to a computing device associated with theclinician.

Clause 25. The method of Clause 24, further comprising: determining,based on the one or more follow-up activities, whether an update to anelectronic record of a patient at an administration system of thehealthcare facility is required; and in response to determining that anupdate to the electronic record is required, causing the alert to bedisplayed adjacent to the electronic record on a display deviceassociated with to the administration system.

Clause 26. The method of Clause 21, further comprising: receivinginformation related to a set of interactions of a clinician of theplurality of clinicians with a medical device; identifying apredetermined care area of the medical device based on locationinformation of the medical device; determining, based on theinformation, a parameter value associated with a medication administeredto a patient; in response to determining that the parameter value isoutside of a predetermined threshold value, updating a medicationcounter associated with the predetermined care area, wherein themedication counter indicates a number of times the medication isadministered using a parameter value outside of the predeterminedthreshold value; determining whether the medication counter satisfies asecond threshold value; and in response to determining that themedication counter satisfies the second threshold value, causing analert identifying the medication and the predetermined care area to bedisplayed on a display device of a drug management system.

Clause 27. The method of Clause 26, further comprising: in response todetermining that the counter satisfies the threshold value, calculating,based at least on the value for the parameter of the medication at whichthe medication is administered, a new value for the parameter; andtransmitting an alert to a user of the drug management system to updatea current value of the parameter to the new value for the parameter.

Clause 28. The method of Clause 26, further comprising: in response todetermining that the medication counter does not satisfy the secondthreshold value, reducing the performance score of the clinician by apredetermined amount; determining whether the reduced performance scoresatisfies a predetermined threshold low performance score; and inresponse to determining that the reduced performance score satisfies thepredetermined threshold low performance score, updating permissions ofassociated with the clinician to electronically prevent the clinicianfrom using the one or more medical devices.

Clause 29. The method of Clause 26, further comprising: in response todetermining that the reduced performance score satisfies a predeterminedthreshold low performance score, assigning a training package to theclinician; determining whether the training package is successfullycompleted; and in response to determining that the training package issuccessfully completed, electronically granting access to the clinicianto use the one or more medical devices.

Clause 30. The method of Clause 26, further comprising: in response todetermining that the reduced performance score satisfies a predeterminedthreshold low performance score, assigning a mentor clinician to theclinician; and electronically preventing the clinician from using amedical device among the one or more medical devices until clinicianidentifying information associated with the mentor clinician isreceived.

Clause 31. A system comprising: a memory storing instructions; and oneor more processors coupled with the memory and configured to execute theinstructions to cause the system to: identify interactions of aplurality of clinicians with one or more medical devices; generate,based on a set of stored rules and one or more interactions of each userof the plurality of clinicians, a performance score for each ofplurality of clinicians; receive a first shift schedule associated withthe plurality of clinicians; determine whether the first shift schedulesatisfies one or more scheduling criteria associated with a healthcarefacility; when the first shift schedule does not satisfy the one or morescheduling criteria and a first performance score for a first cliniciannot satisfying a first evaluation threshold of the one or morescheduling criteria: (1) generate a new second shift schedule for theplurality of clinicians that replaces a first clinician scheduled duringa first time period with a second clinician not currently scheduledduring the time period based on a second performance score of the secondclinician, and (2) electronically prevent the first clinician from usingat least one of the one or more medical devices during the first timeperiod; and cause the new schedule for the shift to be displayed on adisplay device associated with a clinician scheduling system.

Clause 32. The system of Clause 31, wherein the one or more processorsare configured to execute instructions to cause the system to: identify,based on performance scores of a subset of the plurality of clinicians,one or more high performing resource centers; generate a request for oneor more clinicians not among the plurality of clinicians from the one ormore high performing resource centers; and transmit the request to theclinician scheduling system.

Clause 33. The system of Clause 31, wherein the one or more processorsare configured to execute instructions to cause the system to: determinea subset of the plurality of clinicians whose performance scores satisfya threshold low performance score; receive information related tointeractions of a clinician of the subset with a medical device;identify, based on the information, a workflow initiated at the medicaldevice; identify, based on the workflow and the set of stored rules, anext step in the workflow; and cause the next step to be displayed on adisplay device associated with medical device.

Clause 34. The system of Clause 33, wherein the one or more processorsare configured to execute instructions to cause the system to:determine, based on the information related to the one or moreinteractions, one or more follow-up activities for the clinician;generate an alert for the one or more follow-up activities; and transmitthe alert for the one or more follow-up activities to a computing deviceassociated with the clinician.

Clause 35. The system of Clause 34, wherein the one or more processorsare configured to execute instructions to cause the system to:determine, based on the one or more follow-up activities, whether anupdate to an electronic record of a patient at an administration systemof a healthcare facility is required; and when an update to theelectronic record is required, cause the alert to be displayed adjacentto the electronic record on a display device associated with to theadministration system.

Clause 36. The system of Clause 31, wherein the one or more processorsare configured to execute instructions to cause the system to: receiveinformation related to a set of interactions of a clinician of theplurality of clinicians with a medical device; identify a predeterminedcare area of the medical device based on location information of themedical device; determine, based on the information, a parameter valueassociated with a medication administered to a patient; when theparameter value is outside of a predetermined threshold value, update amedication counter associated with the predetermined care area, whereinthe medication counter indicates a number of times the medication isadministered using a parameter value outside of the predeterminedthreshold value; determine whether the medication counter satisfies asecond threshold value; and when the medication counter satisfies thesecond threshold value, causing an alert identifying the medication andthe predetermined care area to be displayed on a display device of adrug management system.

Clause 37. The system of Clause 36, wherein the one or more processorsare configured to execute instructions to cause the system to: when thecounter satisfies the threshold value, calculate, based at least on thevalue for the parameter of the medication at which the medication isadministered, a new value for the parameter; and transmit an alert to auser of the drug management system to update a current value of theparameter to the new value for the parameter.

Clause 38. The system of Clause 36, wherein the one or more processorsare configured to execute instructions to cause the system to: when themedication counter does not satisfy the second threshold value, reducingthe performance score of the clinician by a predetermined amount;determine whether the reduced performance score satisfies apredetermined threshold low performance score; and when the reducedperformance score satisfies the predetermined threshold low performancescore, updating permissions of associated with the clinician toelectronically prevent the clinician from using the one or more medicaldevices.

Clause 39. The system of Clause 36, wherein the one or more processorsare configured to execute instructions to cause the system to: when thereduced performance score satisfies a predetermined threshold lowperformance score, assign a training package to the clinician; determinewhether the training package is successfully completed; and when thetraining package is successfully completed, electronically grant accessto the clinician to use the one or more medical devices.

Clause 40. The system of Clause 36, wherein the one or more processorsare configured to execute instructions to cause the system to: determinethat the reduced performance score satisfies the predetermined thresholdlow performance score, assigning a mentor clinician to the clinician;and electronically prevent the clinician from using a medical deviceamong the one or more medical devices until clinician identifyinginformation associated with the mentor clinician is received.

Clause 41. A method comprising: identifying one or more interactions ofa first user with one or more medical devices; determining, based on theone or more interactions and a predetermined set of rules, a compliancescore associated with the first user; in response to the compliancescore not satisfying a threshold compliance score, reducing an accesslevel of the first user to at least one of the one or more medicaldevices and generating a training program associated with the at leastone medical device and the one or more interactions, wherein reducingthe access level includes reducing a number of respective features ofthe at least one medical device that are available to the first user;and automatically, without user involvement, sending a training packageassociated with the training program to the first user and notifying thefirst user to complete the training program using the training package.

Clause 42. The method of Clause 41, further comprising: receiving arequest for the first user to access the at least one medical device;determining, responsive to the request, that the first user has notcompleted the training program: requiring authorization from a seconduser authorized to use the at least one medical device before grantingthe request for the first user to access the at least one medicaldevice.

Clause 43. The method of Clause 41, wherein the training program isgenerated based on a category associated with the one or moreinteractions and includes one or more training tasks associated with thenumber of respective features of the at least one medical device, andwherein the method further comprises: determining that the first usercompleted the training program, including the one or more trainingtasks; and restoring, responsive to determining that the first usercompleted the training program, the access level of the first user withregard to the at least one medical device.

Clause 44. The method of claim 3, wherein each of the one or morerespective features of the medical device are made available to thefirst user as a corresponding training task associated with each featureis completed by the first user.

Clause 45. A system comprising a memory storing instructions; and one ormore processors configured to execute the instructions to cause thesystem to perform any of the methods of Clauses 41-44.

Clause 46. A non-transitory computer-readable medium storinginstructions thereon that, when executed by one or more computingdevices, case the one or more computing devices to perform one or moreoperations comprising any of the method steps of Clauses 41-44.

Further Consideration

In some embodiments, any of the clauses herein may depend from any oneof the independent clauses or any one of the dependent clauses. In oneaspect, any of the clauses (e.g., dependent or independent clauses) maybe combined with any other one or more clauses (e.g., dependent orindependent clauses). In one aspect, a claim may include some or all ofthe words (e.g., steps, operations, means or components) recited in aclause, a sentence, a phrase or a paragraph. In one aspect, a claim mayinclude some or all of the words recited in one or more clauses,sentences, phrases or paragraphs. In one aspect, some of the words ineach of the clauses, sentences, phrases or paragraphs may be removed. Inone aspect, additional words or elements may be added to a clause, asentence, a phrase or a paragraph. In one aspect, the subject technologymay be implemented without utilizing some of the components, elements,functions or operations described herein. In one aspect, the subjecttechnology may be implemented utilizing additional components, elements,functions or operations.

The previous description is provided to enable any person skilled in theart to practice the various aspects described herein. The previousdescription provides various examples of the subject technology, and thesubject technology is not limited to these examples. Variousmodifications to these aspects will be readily apparent to those skilledin the art, and the generic principles defined herein may be applied toother aspects. Thus, the claims are not intended to be limited to theaspects shown herein, but is to be accorded the full scope consistentwith the language claims, wherein reference to an element in thesingular is not intended to mean “one and only one” unless specificallyso stated, but rather “one or more.” Unless specifically statedotherwise, the term “some” refers to one or more. Pronouns in themasculine (e.g., his) include the feminine and neuter gender (e.g., herand its) and vice versa. Headings and subheadings, if any, are used forconvenience only and do not limit this disclosure.

While the description discusses certain features using a modularinfusion pump as the example medical device, the adaptive controlfeatures may be implemented using different medical devices such asstand-alone infusion pumps, syringe pumps, medication preparationworkstations, or automated medication dispensing cabinets. The predicatewords “configured to,” “operable to,” and “programmed to” do not implyany particular tangible or intangible modification of a subject, but,rather, are intended to be used interchangeably. For example, aprocessor configured to monitor and control an operation or a componentmay also mean the processor being programmed to monitor and control theoperation or the processor being operable to monitor and control theoperation. Likewise, a processor configured to execute code can beconstrued as a processor programmed to execute code or operable toexecute code.

The term automatic, as used herein, may include performance by acomputer or machine without user intervention; for example, byinstructions responsive to a predicate action by the computer or machineor other initiation mechanism. The word “example” is used herein to mean“serving as an example or illustration.” Any aspect or design describedherein as “example” is not necessarily to be construed as preferred oradvantageous over other aspects or designs.

A phrase such as an “aspect” does not imply that such aspect isessential to the subject technology or that such aspect applies to allconfigurations of the subject technology. A disclosure relating to anaspect may apply to all configurations, or one or more configurations.An aspect may provide one or more examples. A phrase such as an aspectmay refer to one or more aspects and vice versa. A phrase such as an“implementation” does not imply that such implementation is essential tothe subject technology or that such implementation applies to allconfigurations of the subject technology. A disclosure relating to animplementation may apply to all implementations, or one or moreimplementations. An implementation may provide one or more examples. Aphrase such as an “implementation” may refer to one or moreimplementations and vice versa. A phrase such as a “configuration” doesnot imply that such configuration is essential to the subject technologyor that such configuration applies to all configurations of the subjecttechnology. A disclosure relating to a configuration may apply to allconfigurations, or one or more configurations. A configuration mayprovide one or more examples. A phrase such as a “configuration” mayrefer to one or more configurations and vice versa.

As used herein, the terms “determine” or “determining” encompass a widevariety of actions. For example, “determining” may include calculating,computing, processing, deriving, generating, obtaining, looking up(e.g., looking up in a table, a database or another data structure),ascertaining and the like via a hardware element without userintervention. Also, “determining” may include receiving (e.g., receivinginformation), accessing (e.g., accessing data in a memory) and the likevia a hardware element without user intervention. “Determining” mayinclude resolving, selecting, choosing, establishing, and the like via ahardware element without user intervention.

As used herein, the terms “provide” or “providing” encompass a widevariety of actions. For example, “providing” may include storing a valuein a location of a storage device for subsequent retrieval, transmittinga value directly to the recipient via at least one wired or wirelesscommunication medium, transmitting or storing a reference to a value,and the like. “Providing” may also include encoding, decoding,encrypting, decrypting, validating, verifying, and the like via ahardware element.

As used herein, the term “message” encompasses a wide variety of formatsfor communicating (e.g., transmitting or receiving) information. Amessage may include a machine readable aggregation of information suchas an XML document, fixed field message, comma separated message, or thelike. A message may, in some implementations, include a signal utilizedto transmit one or more representations of the information. Whilerecited in the singular, it will be understood that a message may becomposed, transmitted, stored, received, etc. in multiple parts.

As used herein, the term “selectively” or “selective” may encompass awide variety of actions. For example, a “selective” process may includedetermining one option from multiple options. A “selective” process mayinclude one or more of: dynamically determined inputs, preconfiguredinputs, or user-initiated inputs for making the determination. In someimplementations, an n-input switch may be included to provide selectivefunctionality where n is the number of inputs used to make theselection.

As user herein, the terms “correspond” or “corresponding” encompasses astructural, functional, quantitative and/or qualitative correlation orrelationship between two or more objects, data sets, information and/orthe like, preferably where the correspondence or relationship may beused to translate one or more of the two or more objects, data sets,information and/or the like so to appear to be the same or equal.Correspondence may be assessed using one or more of a threshold, a valuerange, fuzzy logic, pattern matching, a machine learning assessmentmodel, or combinations thereof.

In any embodiment, data generated or detected can be forwarded to a“remote” device or location, where “remote,” means a location or deviceother than the location or device at which the program is executed. Forexample, a remote location could be another location (e.g., office, lab,etc.) in the same city, another location in a different city, anotherlocation in a different state, another location in a different country,etc. As such, when one item is indicated as being “remote” from another,what is meant is that the two items can be in the same room butseparated, or at least in different rooms or different buildings, andcan be at least one mile, ten miles, or at least one hundred milesapart. “Communicating” information references transmitting the datarepresenting that information as electrical signals over a suitablecommunication channel (e.g., a private or public network). “Forwarding”an item refers to any means of getting that item from one location tothe next, whether by physically transporting that item or otherwise(where that is possible) and includes, at least in the case of data,physically transporting a medium carrying the data or communicating thedata. Examples of communicating media include radio or infra-redtransmission channels as well as a network connection to anothercomputer or networked device, and the internet or including emailtransmissions and information recorded on websites and the like.

All structural and functional equivalents to the elements of the variousaspects described throughout this disclosure that are known or latercome to be known to those of ordinary skill in the art are expresslyincorporated herein by reference and are intended to be encompassed bythe claims. Moreover, nothing disclosed herein is intended to bededicated to the public regardless of whether such disclosure isexplicitly recited in the claims. No claim element is to be construedunder the provisions of 35 U.S.C. § 112, sixth paragraph, unless theelement is expressly recited using the phrase “means for” or, in thecase of a method claim, the element is recited using the phrase “stepfor.” Furthermore, to the extent that the term “include,” “have,” or thelike is used in the description or the claims, such term is intended tobe inclusive in a manner similar to the term “comprise” as “comprise” isinterpreted when employed as a transitional word in a claim.

What is claimed is:
 1. A method performed by one or more computingdevices, comprising: identifying interactions of a first user with aplurality of medical devices in a healthcare organization, one of theinteractions including a response time to one or more alarms generatedby a respective medical device of the plurality of medical devices, theplurality of medical devices including an infusion device, a syringepump, a medication preparation workstation, or an automated medicationdispensing cabinet; determining, based on the identified interactionsand a predetermined set of rules, a compliance score associated with thefirst user; in response to the compliance score not satisfying athreshold compliance score, automatically, without user involvement:transmitting an instruction to at least one medical device of theplurality of medical devices to cause an access level of the first userto the at least one medical device to be reduced by denying access to anumber of respective features of the at least one medical device thatare available to the first user; generating a training programassociated with the at least one medical device; sending a trainingpackage associated with the training program to the first user andnotifying the first user to complete the training program using thetraining package, and restoring the access level of the first user withregard to the at least one medical device responsive to the first usercompleting the training program.
 2. The method of claim 1, furthercomprising: receiving a request for the first user to access the atleast one medical device; determining, responsive to the request, thatthe first user has not completed the training program; requiringauthorization from a second user authorized to use the at least onemedical device before granting the request for the first user to accessthe at least one medical device.
 3. The method of claim 1, wherein thetraining program is generated based on a category associated with theinteractions and includes one or more training tasks associated with thenumber of respective features of the at least one medical device, andwherein the method further comprises: determining that the first usercompleted the training program, including the one or more trainingtasks.
 4. The method of claim 3, wherein each of the one or morerespective features of the medical device are made available to thefirst user as a corresponding training task associated with each featureis completed by the first user.
 5. The method of claim 1, furthercomprising: assigning a performance score to each of a plurality ofusers based on medical device interactions performed by the plurality ofusers with respect to the one or more medical devices; receiving a firstshift schedule associated with the plurality of users; determiningwhether the first shift schedule satisfies one or more schedulingcriteria associated with a healthcare facility; in response todetermining that the first shift schedule does not satisfy the one ormore scheduling criteria and a first performance score for a first usernot satisfying a first evaluation threshold of the one or morescheduling criteria: (1) generating a new second shift schedule for theplurality of users that replaces a first user scheduled during a firsttime period with a second user not currently scheduled during the timeperiod based on a second performance score of the second user, and (2)electronically preventing the first user from using at least one of theone or more medical devices during the first time period; and causingthe new schedule for the shift to be displayed on a display deviceassociated with a user scheduling system.
 6. The method of claim 5,further comprising: identifying, based on performance scores of a subsetof the plurality of users, one or more high performing resource centers;generating a request for one or more users not among the plurality ofusers from the one or more high performing resource centers; andtransmitting the request to the user scheduling system.
 7. The method ofclaim 5, further comprising: determining a subset of the plurality ofusers whose performance scores satisfy a threshold low performancescore; receiving information related to interactions of a user of thesubset with a medical device; identifying, based on the information, aworkflow initiated at the medical device; identifying, based on theworkflow and a set of stored rules, a next step in the workflow; andcausing the next step to be displayed on a display device associatedwith medical device.
 8. The method of claim 7, further comprising:determining, based on the information related to the interactions, oneor more follow-up activities for the user; and generating an alert forthe one or more follow-up activities; transmitting the alert for the oneor more follow-up activities to a computing device associated with theuser; determining, based on the one or more follow-up activities,whether an update to an electronic record of a patient at anadministration system of the healthcare facility is required; and inresponse to determining that an update to the electronic record isrequired, causing the alert to be displayed adjacent to the electronicrecord on a display device associated with to the administration system.9. The method of claim 5, further comprising: receiving informationrelated to a set of interactions of a user of the plurality of userswith a medical device; identifying a predetermined care area of themedical device based on location information of the medical device;determining, based on the information, a parameter value associated witha medication administered to a patient; in response to determining thatthe parameter value is outside of a predetermined threshold value,updating a medication counter associated with the predetermined carearea, wherein the medication counter indicates a number of times themedication is administered using a parameter value outside of thepredetermined threshold value; determining whether the medicationcounter satisfies a second threshold value; and in response todetermining that the medication counter satisfies the second thresholdvalue, causing an alert identifying the medication and the predeterminedcare area to be displayed on a display device of a drug managementsystem.
 10. The method of claim 9, further comprising: in response todetermining that the counter satisfies the threshold value, calculating,based at least on the value for the parameter of the medication at whichthe medication is administered, a new value for the parameter; andtransmitting an alert to a user of the drug management system to updatea current value of the parameter to the new value for the parameter. 11.The method of claim 9, further comprising: in response to determiningthat the medication counter does not satisfy the second threshold value,reducing the performance score of the user by a predetermined amount;determining whether the reduced performance score satisfies apredetermined threshold low performance score; and in response todetermining that the reduced performance score satisfies thepredetermined threshold low performance score, updating permissions ofassociated with the user to electronically prevent the user from usingthe one or more medical devices.
 12. The method of claim 9, furthercomprising: in response to determining that the reduced performancescore satisfies a predetermined threshold low performance score,assigning a mentor user to the user; and electronically preventing theuser from using a medical device among the one or more medical devicesuntil user identifying information associated with the mentor user isreceived.
 13. A system comprising: a memory storing instructions; andone or more processors configured to execute the instructions to causethe system to: identify interactions of a first user with a plurality ofmedical devices in a healthcare organization, one of the interactionsincluding a response time to one or more alarms generated by arespective medical device of a plurality of medical devices, theplurality of medical devices including an infusion device, a syringepump, a medication preparation workstation, or an automated medicationdispensing cabinet; determine, based on the identified interactions anda predetermined set of rules, a compliance score associated with thefirst user; in response to the compliance score not satisfying athreshold compliance score, automatically, without user involvement:transmit an instruction to at least one medical device of the pluralityof medical devices to cause an access level of the first user to the atleast one medical device to be reduced by denying access to a number ofrespective features of the at least one medical device that areavailable to the first user; and generate a training program associatedwith the at least one medical device; send a training package associatedwith the training program to the first user and notifying the first userto complete the training program using the training package; and restorethe access level of the first user with regard to the at least onemedical device responsive to the first user completing the trainingprogram.
 14. The system of claim 13, wherein the one or more processorsare configured to execute the instructions to further cause the systemto: receive a request for the first user to access the at least onemedical device; determine, responsive to the request, that the firstuser has not completed the training program; require authorization froma second user authorized to use the at least one medical device beforegranting the request for the first user to access the at least onemedical device.
 15. The system of claim 13, wherein the one or moreprocessors are configured to execute the instructions to further causethe system to: determine that the first user completed the trainingprogram.
 16. The system of claim 15, wherein the training program isgenerated based on a category associated with the one or moreinteractions and includes one or more training tasks associated with thenumber of respective features of the at least one medical device, andwherein each of the one or more respective features of the medicaldevice are made available to the first user as a corresponding trainingtask associated with each feature is completed by the first user. 17.The system of claim 13, wherein the one or more processors areconfigured to execute the instructions to further cause the system to:assign a performance score to each of a plurality of users based onmedical device interactions performed by the plurality of users withrespect to the one or more medical devices; receive a first shiftschedule associated with the plurality of users; determine whether thefirst shift schedule satisfies one or more scheduling criteriaassociated with a healthcare facility; in response to determining thatthe first shift schedule does not satisfy the one or more schedulingcriteria and a first performance score for a first user not satisfying afirst evaluation threshold of the one or more scheduling criteria: (1)generate a new second shift schedule for the plurality of users thatreplaces a first user scheduled during a first time period with a seconduser not currently scheduled during the time period based on a secondperformance score of the second user, and (2) electronically prevent thefirst user from using at least one of the one or more medical devicesduring the first time period; and cause the new schedule for the shiftto be displayed on a display device associated with a user schedulingsystem.
 18. The system of claim 17, wherein the one or more processorsare configured to execute the instructions to further cause the systemto: determine a subset of the plurality of users whose performancescores satisfy a threshold low performance score; receive informationrelated to interactions of a user of the subset with a medical device;identify, based on the information, a workflow initiated at the medicaldevice; identify, based on the workflow and a set of stored rules, anext step in the workflow; and cause the next step to be displayed on adisplay device associated with medical device.
 19. The system of claim18, wherein the one or more processors are configured to execute theinstructions to further cause the system to: determine, based on theinformation related to the one or more interactions, one or morefollow-up activities for the user; and generate an alert for the one ormore follow-up activities; transmit the alert for the one or morefollow-up activities to a computing device associated with the user;determine, based on the one or more follow-up activities, whether anupdate to an electronic record of a patient at an administration systemof the healthcare facility is required; and in response to determiningthat an update to the electronic record is required, cause the alert tobe displayed adjacent to the electronic record on a display deviceassociated with to the administration system.
 20. The system of claim13, wherein the one or more processors are configured to execute theinstructions to further cause the system to: identify a predeterminedcare area of the medical device based on location information of themedical device; determine, based on the information, a parameter valueassociated with a medication administered to a patient; in response todetermining that the parameter value is outside of a predeterminedthreshold value, update a medication counter associated with thepredetermined care area, wherein the medication counter indicates anumber of times the medication is administered using a parameter valueoutside of the predetermined threshold value; determine whether themedication counter satisfies a second threshold value; and in responseto determining that the medication counter satisfies the secondthreshold value, cause an alert identifying the medication and thepredetermined care area to be displayed on a display device of a drugmanagement system.
 21. The system of claim 20, wherein the one or moreprocessors are configured to execute the instructions to further causethe system to: in response to determining that the medication counterdoes not satisfy the second threshold value, reduce the performancescore of the user by a predetermined amount; assign a mentor user to theuser responsive to determining that the reduced performance scoresatisfies a predetermined threshold low performance score; andelectronically prevent the user from using a medical device among theone or more medical devices until user identifying informationassociated with the mentor user is received.
 22. A non-transitorycomputer-readable medium storing instructions thereon that, whenexecuted by one or more computing devices, case the one or morecomputing devices to perform one or more operations comprising: identifyinteractions of a first user with a plurality of medical devices in ahealthcare organization, one of the interactions including a responsetime to one or more alarms generated by a respective medical device of aplurality of medical devices, the plurality of medical devices includingan infusion device, a syringe pump, a medication preparationworkstation, or an automated medication dispensing cabinet; determine,based on the identified interactions and a predetermined set of rules, acompliance score associated with the first user; in response to thecompliance score not satisfying a threshold compliance score,automatically, without user involvement: transmit an instruction to atleast one medical device of the plurality of medical devices to cause anaccess level of the first user to the at least one medical device to bereduced by denying access to a number of respective features of the atleast one medical device that are available to the first user; andgenerate a training program associated with the at least one medicaldevice; send a training package associated with the training program tothe first user and notifying the first user to complete the trainingprogram using the training package; and restore the access level of thefirst user with regard to the at least one medical device responsive tothe first user completing the training program.